Individual
SUSAN K WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16007 VIA SHAVANO, SUITE 101, SAN ANTONIO, TX 78249
(210) 615-8900
(210) 615-9400
Mailing address
16007 VIA SHAVANO, STE. 101, SAN ANTONIO, TX 78249
(210) 615-8900
(210) 615-9400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
K1141
TX
2084P0804X
Child & Adolescent Psychiatry Physician
K1141
TX
Other
Enumeration date
11/22/2006
Last updated
02/09/2010
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