MR. ISRAEL D. CUSTODIO, PA-C
Medical Practice at Fredericksburg Rd, San Antonio, TX

License number
Texas PA01549
Category
Nursing
Type
Medical
Address
Address
4805 Fredericksburg Rd, San Antonio, TX 78229
Phone
(210) 979-7999
(210) 798-2457 (Fax)
National Provider ID: 1366570087
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about ISRAEL D. CUSTODIO at bizstanding.com

ISRAEL D. CUSTODIO, PLLC

5011 Lakebend East Dr, San Antonio, TX 78244

Status:
Inactive
Registration:
Apr 22, 2005
State ID:
0800483578
PHYSICIAN:
Isroue D Custrodio (PHYSICIAN)
Agent:
Israel D. Custodio,5011 Lk Bnd E Dr, San Antonio, TX 78244 (Physical)
TIN:
32017283691

Professional information

Israel D Custodio Photo 1

Israel D Custodio, San Antonio TX
Specialties:
Physician Assistant (PA)
Address:
4805 Fredericksburg Rd, San Antonio 78229
(210) 979-7999 (Phone), (210) 798-2457 (Fax)
Languages:
English
Background:
Board Action:  1 time(s)

Israel David Custodio Photo 2

Israel David Custodio, San Antonio TX
Specialties:
Physician Assistant
Address:
4805 Fredericksburg Rd, San Antonio, TX 78229
94 Briggs St, San Antonio, TX 78224

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