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Organization
DIABETES AND GLANDULAR DISEASE CLINIC PA
Active
Organization
DIABETES AND GLANDULAR DISEASE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB VADAKEKALAM MD (PRESIDENT)
(210) 615-5541
Entity
Organization
Contact information
Practice address
5107 MEDICAL DR, SAN ANTONIO, TX 78229
(210) 614-8612
(210) 615-5596
Mailing address
5107 MEDICAL DR, SAN ANTONIO, TX 78229
(210) 614-8612
(210) 615-5596
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121762202
—
TX
Enumeration date
08/29/2006
Last updated
06/09/2022
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