Provider Demographics
NPI:1134441074
Name:SEGUNDO ABRAHAM BRIONES M.D. P.A.
Entity type:Organization
Organization Name:SEGUNDO ABRAHAM BRIONES M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEGUNDO
Authorized Official - Middle Name:ABRAHAM
Authorized Official - Last Name:BRIONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:210-495-6515
Mailing Address - Street 1:18142 EMERALD FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3620
Mailing Address - Country:US
Mailing Address - Phone:210-421-7569
Mailing Address - Fax:
Practice Address - Street 1:16614 SAN PEDRO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2223
Practice Address - Country:US
Practice Address - Phone:210-495-6515
Practice Address - Fax:210-495-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8930261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1689688608OtherTYPE 2 NPI
TX00530MMedicare PIN