Individual
MR. WALTER RUSSELL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5131 ROOSEVELT AVE, SAN ANTONIO, TX 78214-3219
(210) 526-5213
(210) 626-1191
Mailing address
5131 ROOSEVELT AVE, SAN ANTONIO, TX 78214-3219
(210) 526-5213
(210) 626-1191
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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