MEDICARE: ROBERT A BORREGO III MD

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
1	207R00000X	Internal Medicine Physician	H9041	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700872439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A BORREGO III MD

Provider Business Mailing Address
First Line	:	359 E HILDEBRAND AVE
Second Line	:	SUITE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-2436
Country	:	US
Telephone Number	:	210-822-5524
Fax Number	:	210-822-4661

Provider Business Practice Location Address
First Line	:	359 E HILDEBRAND AVE
Second Line	:	SUITE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-2436
Country	:	US
Telephone Number	:	210-822-5524
Fax Number	:	210-822-4661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	05/21/2008

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