Individual
DR. STEPHEN GLENN WALLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-6583
Mailing address
232 COLLEGE BLVD, ALAMO HEIGHTS, TX 78209-4517
(210) 829-5575
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M0303
TX
Other
Enumeration date
01/10/2006
Last updated
07/08/2007
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