NPI 1003072646 · live from the CMS NPI Registry
Polo Alberto Banuelos, M.D.
Psychiatry & Neurology, Neurology in San Antonio, TX. National Provider Identifier 1003072646, active.
NPI record
| NPI | 1003072646 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 11212 State Highway 151, Medical Plaza 1, Suite 200, San Antonio, TX 78251 |
| Practice phone | 210-520-7160 |
| Mailing address | 9730 Westover Hills Blvd Ste 105, San Antonio, TX 78251 |
| Enumerated | August 4, 2008 |
| Last updated | February 27, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology | 2084N0400X | M9832 (TX) |
| Psychiatry & Neurology, Neurology primary | 2084N0400X | ME158919 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.