| Drwlc1 | |
|
5539 N W Loop 1604 Suite 104 San Antonio TX 78253-1708 | |
| (210) 495-2117 | |
| (888) 893-4363 |
| Full Name | Drwlc1 |
|---|---|
| Speciality | Family Medicine - Obesity Medicine |
| Location | 5539 N W Loop 1604, San Antonio, Texas |
| Authorized Official Name and Position | Tamyra L Rogers (OWNER) |
| Authorized Official Contact | 2104952117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Drwlc1 2815 N Loop 1604 E Suite 105 San Antonio TX 78232-1708 Ph: (210) 495-2117 | Drwlc1 5539 N W Loop 1604 Suite 104 San Antonio TX 78253-1708 Ph: (210) 495-2117 |
| NPI Number | 1710364708 |
|---|---|
| Provider Enumeration Date | 04/29/2015 |
| Last Update Date | 04/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710364708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | L3099 (Texas) | Primary |
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