Provider Demographics
NPI:1528055167
Name:CORTEZ, CRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7579 N LOOP 1604 W STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2782
Mailing Address - Country:US
Mailing Address - Phone:210-695-1900
Mailing Address - Fax:210-695-1901
Practice Address - Street 1:6800 W IH 10 STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2041
Practice Address - Country:US
Practice Address - Phone:210-695-1900
Practice Address - Fax:210-695-1901
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165028503Medicaid
TX8B6816Medicare ID - Type Unspecified
TX165028501Medicaid