| Doctor Name: | ROBERT EDWARD FADAL |
| NPI Number: | 1568637171 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | J0822 |
| Business Practice Address: | 801 Timber Elm Seguin, TX - 781551135 |
| Business Phone Number: | 2105735795 |
| Business Fax Number: | 8305574117 |
| Mailing Address: | 4115 Medical Drive, Suite 500 SAN ANTONIO |
| State: | TX |
| Postal Code: | 782295638 |
| Phone Number: | 2106143063 |
| Fax Number: | 2106146996 |
| NPI Enumeration Date: | 04/24/2008 |
| NPI Last Update Date: | 03/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | J0822 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |