Organization
RETINA INSTITUTE OF SOUTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDALL BAUMAN M.D. (OWNER)
(210) 654-0400
Entity
Organization
Contact information
Practice address
11651 TOEPPERWEIN RD, STE 201, LIVE OAK, TX 78233-3147
(210) 654-0400
(210) 654-0460
Mailing address
137 PRIMROSE PL, SAN ANTONIO, TX 78209-3832
(210) 654-0400
(210) 654-0460
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J4706
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034567003
—
TX
05
—
175842701
—
TX
Enumeration date
03/26/2007
Last updated
12/08/2014
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