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Organization
WELLMED MEDICAL GROUP, PA
Active
Organization
WELLMED MEDICAL GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS O HERNANDEZ MD (DIRECTOR)
(210) 617-4706
Entity
Organization
Contact information
Practice address
4438 CENTERVIEW, SAN ANTONIO, TX 78228-1440
(210) 280-0040
(210) 280-0060
Mailing address
19500 IH-10W, MS1-5030, ATTN: LICENSING & REGULATORY, SAN ANTONIO, TX 78257-1285
(210) 617-4706
(210) 617-4075
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093841-02
—
TX
Enumeration date
07/06/2005
Last updated
04/18/2023
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