MEDICARE: DR. RENATO A GERALDE DO

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	207Q00000X	Family Medicine Physician	M0728	TX

General Provider Information

NPI Number	:	1801894944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENATO A GERALDE DO

Provider Business Mailing Address
First Line	:	150 E SONTERRA BLVD
Second Line	:	SUITE 220
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4098
Country	:	US
Telephone Number	:	210-481-6800
Fax Number	:	210-481-1444

Provider Business Practice Location Address
First Line	:	540 OAK CENTRE DR STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3936
Country	:	US
Telephone Number	:	210-757-3172
Fax Number	:

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	11/20/2025

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