Individual
THERESA MCALISTER MAIRSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
59MDW/GE 1100 WILFORD HALL LOOP, BLDG 4554, JBSA-LACKLAND, TX 78236-7823
(913) 909-4219
Mailing address
5788 ECKHERT RD, SAN ANTONIO, TX 78240-3900
(210) 450-6450
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
208D00000X
General Practice Physician
Primary
0101286696
VA
Other
Enumeration date
04/03/2023
Last updated
03/21/2026
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