# ELEMENTAL WEIGHT LOSS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285084939
- **Authorized official:** DR. MEGAN ROSE-LEE WILLIAMS KHMELEV MD (PRESIDENT)
- **Authorized official phone:** (210) 960-2639

## Contact information

- **Practice address:** 9150 HUEBNER RD, STE 160, SAN ANTONIO, TX 78240-1558
- **Practice address phone:** (210) 960-2639
- **Practice address fax:** (210) 845-1832
- **Mailing address:** 9150 HUEBNER RD, STE 160, SAN ANTONIO, TX 78240-1558
- **Mailing address phone:** (210) 960-2639
- **Mailing address fax:** (210) 845-1832

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | N1222 | TX | — |

## Other

- **Enumeration date:** 06/14/2016
- **Last updated:** 12/30/2016