Basic Information
Provider Information
NPI: 1578519609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROIG
FirstName: CHESTER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 681149
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782681149
CountryCode: US
TelephoneNumber: 2105753595
FaxNumber: 2105756298
Practice Location
Address1: 9901 IH 10 W
Address2: SUITE 400
City: SAN ANTONIO
State: TX
PostalCode: 782302246
CountryCode: US
TelephoneNumber: 2105586288
FaxNumber: 2105586289
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XE3759TXY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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