Basic Information
| Provider Information | |||||||||
| NPI: | 1093946188 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FERMIN BRIONES JR MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4242 MEDICAL DRIVE | ||||||||
| Address2: | STE 6300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782295640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106148400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4242 MEDICAL DRIVE | ||||||||
| Address2: | STE 6300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782295640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106148400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 05/24/2011 | ||||||||
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| AuthorizedOfficialLastName: | BRIONES | ||||||||
| AuthorizedOfficialFirstName: | FERMIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2108728060 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | N0660 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.