Basic Information
Provider Information
NPI: 1922447648
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BYRNE
FirstName: JOHN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 315 N SAN SABA STE 1135
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782073255
CountryCode: US
TelephoneNumber: 2107043030
FaxNumber: 2107044527
Practice Location
Address1: 315 N SAN SABA STE 930
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782073154
CountryCode: US
TelephoneNumber: 2107043200
FaxNumber: 2107042718
Other Information
ProviderEnumerationDate: 06/15/2013
LastUpdateDate: 06/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101XR2295TXY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

No ID Information.


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