Provider Demographics
NPI:1851542542
Name:EMAN MINA MD
Entity type:Organization
Organization Name:EMAN MINA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EMAN
Authorized Official - Middle Name:G-F
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-497-7700
Mailing Address - Street 1:PO BOX 461467
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78246-1467
Mailing Address - Country:US
Mailing Address - Phone:210-497-7700
Mailing Address - Fax:
Practice Address - Street 1:18626 HARDY OAK BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4219
Practice Address - Country:US
Practice Address - Phone:210-497-7700
Practice Address - Fax:210-402-6815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0981261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center