Individual
CLINTON R WOOSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 743-2100
(210) 702-6215
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
L7263
TX
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
L7263
TX
2080P0203X
Pediatric Critical Care Medicine Physician
MD2017-0116
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163061801
CIDC
TX
05
—
163061802
—
TX
05
—
163061815
—
TX
01
—
163061816
CSHCN
TX
Enumeration date
07/30/2006
Last updated
10/30/2024
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