# DRWLC3 LLC

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

## Provider details

- **NPI number:** 1629455613
- **Authorized official:** TAMYRA L ROGERS M.D. (OWNER)
- **Authorized official phone:** (210) 495-2117

## Contact information

- **Practice address:** 24200 IH-10 WEST, SUITE107, SA, TX 78257
- **Practice address phone:** (210) 495-2117
- **Practice address fax:** (888) 893-4363
- **Mailing address:** 2815 N LOOP 1604 E, SUITE 105, SAN ANTONIO, TX 78232-1708
- **Mailing address phone:** (210) 495-2117
- **Mailing address fax:** (888) 893-4363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | L3099 | TX | Yes |

## Other

- **Enumeration date:** 04/29/2015
- **Last updated:** 04/29/2015