Basic Information
| Provider Information | |||||||||
| NPI: | 1144295064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CABRERA | ||||||||
| FirstName: | TIMOTEO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16620 N US HIGHWAY 281 | ||||||||
| Address2: | STE 300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782322327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106141231 | ||||||||
| FaxNumber: | 2106160704 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 N FRIO ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782073034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104877827 | ||||||||
| FaxNumber: | 2104877860 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2006 | ||||||||
| LastUpdateDate: | 12/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | L0060 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 145150202 | 05 | TX | MEDICAID |