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Organization
SAN ANTONIO WEIGHTLOSS LLC
Active
Organization
SAN ANTONIO WEIGHTLOSS LLC
Active
Other names
Medi Weightloss Clinic San Antonio
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS K WILLETT (MANAGING MEMBER)
(813) 225-1051
Entity
Organization
Contact information
Practice address
11703 HUEBNER RD, SUITE 100, SAN ANTONIO, TX 78230-1201
(210) 697-9500
Mailing address
412 E MADISON ST, SUITE 1100, TAMPA, FL 33602-4601
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
NULL
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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