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Organization
MARTIN J. WIESENTHAL, MD, PA
Active
Organization
MARTIN J. WIESENTHAL, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN J. WIESENTHAL M.D. (PRESIDENT)
(210) 614-3365
Entity
Organization
Contact information
Practice address
8038 WURZBACH RD, SUITE 320, SAN ANTONIO, TX 78229-3817
(210) 614-3365
(210) 615-3757
Mailing address
PO BOX 66, SAN ANTONIO, TX 78291-0066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E4763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219489601
—
TX
Enumeration date
08/28/2008
Last updated
06/08/2011
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