Basic Information
| Provider Information | |||||||||
| NPI: | 1821035171 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SYMON | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1320 WONDER WORLD DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786667558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123963911 | ||||||||
| FaxNumber: | 5123530807 | ||||||||
| Practice Location | |||||||||
| Address1: | 1320 WONDER WORLD DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786667558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123963911 | ||||||||
| FaxNumber: | 5123530807 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 07/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G0181 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 123226603 | 05 | TX | MEDICAID | 340877YMG2 | 01 | MEDICARE | OTHER | P01306156 | 01 | RR MEDICARE | OTHER |