# DIABETES AND GLANDULAR DISEASE CLINIC CERTIFIED DIABETES EDUCATION CEN

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

## Provider details

- **NPI number:** 1629391842
- **Authorized official:** MR. JOSEPH BAGWELL MT (DIRECTOR OF CLINIC OPERATIONS)
- **Authorized official phone:** (210) 615-5541

## Contact information

- **Practice address:** 5107 MEDICAL DR, SAN ANTONIO, TX 78229-4801
- **Practice address phone:** (210) 614-8612
- **Practice address fax:** (210) 615-1666
- **Mailing address:** 5107 MEDICAL DR, SAN ANTONIO, TX 78229-4801
- **Mailing address phone:** (210) 614-8612
- **Mailing address fax:** (210) 615-1666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/02/2010
- **Last updated:** 08/24/2023