Basic Information
Provider Information
NPI: 1396721155
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARBONA
FirstName: JOSE
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8401 DATAPOINT, SUITE 600
Address2: P. O. BOX 29441
City: SAN ANTONIO
State: TX
PostalCode: 782290441
CountryCode: US
TelephoneNumber: 2106167796
FaxNumber: 2106167799
Practice Location
Address1: 8401 DATAPOINT DR STE 600
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782295907
CountryCode: US
TelephoneNumber: 2106167700
FaxNumber: 2106167709
Other Information
ProviderEnumerationDate: 12/22/2005
LastUpdateDate: 03/16/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085B0100XG7126TXN Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085R0202XG7126TXY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085U0001XG7126TXN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound

ID Information
IDTypeStateIssuerDescription
8L2688201TXMEDICARE - STRICOTHER
1294274-0805TX MEDICAID
1294274-0705TX MEDICAID
P0082994301TXRAILROAD MEDICAREOTHER
1294274-0905TX MEDICAID
P0084567201TXRAILROAD MEDICAREOTHER
G712601TXTEXAS MEDICAL LICENSEOTHER


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