Individual
MRS. BETH ANN WICHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12650 NACGODOCHES, SAN ANTONIO, TX 78217
(210) 656-4363
(210) 599-1251
Mailing address
12650 NACGODOCHES, SAN ANTONIO, TX 78217
(210) 656-4363
(210) 599-1251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H7845
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8K4071
MEDICARE PTAN
TX
Enumeration date
09/07/2006
Last updated
06/29/2010
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