Quintanilla, Mario A
Quintanilla, Mario A is an individual health care provider with primary practice located at 4444 Corona Dr Ste 150 , Corpus Christi TX 78411-4300. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Quintanilla, Mario A can be contacted via phone (361) 993-4835.Contact Information
Primary practice address
4444 Corona Dr Ste 150
Corpus Christi TX 78411-4300
Phone: (361) 993-4835
Fax: (361) 993-7043
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | F1201 | Texas |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | F1201 | Texas |
Profile Details
NPI number | 1871552729 |
---|---|
LBN Legal business name | Quintanilla, Mario A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 20th, 2006 |
Last updated | Mar 28th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1871552729 | NPPES |
Texas | MEDICAID | 139788728 | |
Texas | Other | 8FT501 |
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