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NPI Code Detail

MEDICARE: MARISSA S EMADI MD

MEDICARE: MARISSA S EMADI 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
1207Q00000XFamily Medicine PhysicianT5308TX

General Provider Information

NPI Number : 1912469081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA S EMADI MD
Provider Business Mailing Address
First Line : 903 W MARTIN ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-0903
Country : US
Telephone Number : 210-358-3985
Fax Number : 210-358-5942
Provider Business Practice Location Address
First Line : 1831 S GENERAL MCMULLEN DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78226-1190
Country : US
Telephone Number : 210-644-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2019
Last Update Date : 05/14/2024

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Directions to “ MARISSA S EMADI MD” Practice Location

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