Basic Information
| Provider Information | |||||||||
| NPI: | 1467645648 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERNANDEZ FALCON | ||||||||
| FirstName: | CRISTIAN | ||||||||
| MiddleName: | PABLO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7703 FLOYD CURL DR | ||||||||
| Address2: | MC7977 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104509000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 903 W MARTIN ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782070903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103583985 | ||||||||
| FaxNumber: | 2103585942 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 05/29/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N6294 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | -002 -003 | 01 | VA | TRICARE/CHAMPUS | OTHER | 09400 | 01 | NC | NC BC/BS | OTHER | 2180442 | 01 | VA | UHC/MAMSI | OTHER | 355581 | 01 | VA | ANTHEM - GHENT FAMILY MEDICINE | OTHER | PAR | 01 | VA | VA HEALTH NETWORK | OTHER | 9879170 | 01 | VA | AETNA | OTHER | PAR | 01 | VA | USA MANAGED CARE | OTHER | PAR | 01 | VA | CORVEL/CORCARE | OTHER | 282301502 | 05 | TX | MEDICAID | 355583 | 01 | VA | ANTHEM - PORTSMOUTH FAMILY MEDICINE | OTHER | PAR | 01 | VA | FIRST HEALTH COMMERCIAL | OTHER | 1467645648 | 05 | VA | MEDICAID | 5725950 | 01 | VA | CIGNA | OTHER | 10033743 | 01 | VA | SENTARA/OPTIMA | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | 5909400 | 05 | NC | MEDICAID | PAR | 01 | VA | VA PREMIER HEALTH | OTHER |