Provider Demographics
NPI:1720894413
Name:CHERRY, RONALD D (CSFA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:D
Last Name:CHERRY
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3463 MAGIC DR STE 355
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2974
Mailing Address - Country:US
Mailing Address - Phone:210-614-8101
Mailing Address - Fax:
Practice Address - Street 1:3463 MAGIC DR STE 355
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2974
Practice Address - Country:US
Practice Address - Phone:210-614-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206789246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant