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Individual

BLAKE WASSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
5282 MEDICAL DR STE 250, SAN ANTONIO, TX 78229-6039
(972) 644-2100
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000

Taxonomy

Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
67146
TX

Other

Enumeration date
11/21/2023
Last updated
11/21/2023
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