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NPI Code Detail

MEDICARE: DR. ALICIA VALERIUS TEZEL M.D.

MEDICARE: DR. ALICIA VALERIUS TEZEL M.D.
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
12080P0006XDevelopmental - Behavioral Pediatrics PhysicianJ0309TX
2208000000XPediatrics PhysicianJ0309TX

General Provider Information

NPI Number : 1942206396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALICIA VALERIUS TEZEL M.D.
Provider Business Mailing Address
First Line : 14100 SAN PEDRO AVE STE 412
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-2009
Country : US
Telephone Number : 210-281-8669
Fax Number : 210-314-5044
Provider Business Practice Location Address
First Line : 24200 IH 10 W STE 108
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78257-1150
Country : US
Telephone Number : 210-263-9443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/22/2023

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