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Organization
ELEMENTAL WEIGHT LOSS CLINIC
Active
Organization
ELEMENTAL WEIGHT LOSS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGAN ROSE-LEE WILLIAMS KHMELEV MD (PRESIDENT)
(210) 960-2639
Entity
Organization
Contact information
Practice address
9150 HUEBNER RD, STE 160, SAN ANTONIO, TX 78240-1558
(210) 960-2639
(210) 845-1832
Mailing address
9150 HUEBNER RD, STE 160, SAN ANTONIO, TX 78240-1558
(210) 960-2639
(210) 845-1832
Taxonomy
Speciality
Code
Description
License number
State
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
Primary
—
NULL
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
N1222
TX
Other
Enumeration date
06/14/2016
Last updated
12/30/2016
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