Basic Information
Provider Information
NPI: 1124280920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TREAT
FirstName: ERIC
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8109 FREDERICKSBURG RD
Address2: PHYSICIAN PRACTICE SERVICES
City: SAN ANTONIO
State: TX
PostalCode: 78229
CountryCode: US
TelephoneNumber: 2105758425
FaxNumber: 2105758004
Practice Location
Address1: 8201 EWING HALSELL DR
Address2: 2ND FLOOR
City: SAN ANTONIO
State: TX
PostalCode: 78229
CountryCode: US
TelephoneNumber: 2105758425
FaxNumber: 2105758004
Other Information
ProviderEnumerationDate: 07/02/2008
LastUpdateDate: 08/27/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
204F00000XQ4702TXN Allopathic & Osteopathic PhysiciansTransplant Surgery 
208800000XQ4702TXY Allopathic & Osteopathic PhysiciansUrology 

No ID Information.


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