Individual
WILLIAM STANLEY VYDRZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.P.
Contact information
Practice address
610 N. MAIN AVENUE, SAN ANTONIO, TX 78205-1204
(210) 225-6508
(210) 225-1486
Mailing address
610 NORTH MAIN, SECOND FLOOR, SAN ANTONIO, TX 78205-1204
(210) 237-4358
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
1252
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1252
TEXAS PROSTHETIC LICENSE
TX
Enumeration date
09/10/2012
Last updated
04/05/2023
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