Provider Demographics
NPI:1386624740
Name:CENTENO, ARTHUR S (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:S
Last Name:CENTENO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7909 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3400
Mailing Address - Country:US
Mailing Address - Phone:210-614-4544
Mailing Address - Fax:210-582-5522
Practice Address - Street 1:414 NAVARRO ST
Practice Address - Street 2:SUITE# 900
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2516
Practice Address - Country:US
Practice Address - Phone:210-474-7020
Practice Address - Fax:210-226-2192
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF3823208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105285402Medicaid
TX105285402Medicaid
TX86W493Medicare ID - Type Unspecified