Individual
TYRESE LONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12706 GOLD SPANIARD, SAN ANTONIO, TX 78253-5486
(516) 859-0103
Mailing address
12706 GOLD SPANIARD, SAN ANTONIO, TX 78253-5486
(516) 859-0103
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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