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NPI Code Detail

MEDICARE: JULIO QUINTANILLA

MEDICARE: JULIO QUINTANILLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1588169510
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIO QUINTANILLA
Provider Business Mailing Address
First Line : 711 W 32ND ST APT 109
Second Line :
City : AUSTIN
State : TX
Zip : 78705-2202
Country : US
Telephone Number : 956-605-2454
Fax Number :
Provider Business Practice Location Address
First Line : 2409 UNIVERSITY AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78712-1112
Country : US
Telephone Number : 956-605-2454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2018
Last Update Date : 03/30/2018

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Directions to “ JULIO QUINTANILLA ” Practice Location

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