Organization
PERSONALIZED PRESCRIPTION PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD EWESUEDO M.D (MEDICAL DIRECTOR)
(210) 625-1171
Entity
Organization
Contact information
Practice address
7800 IH 10 WEST, SUITE 612, SAN ANTONIO, TX 78230
(210) 253-9947
Mailing address
PO BOX 40116, SAN ANTONIO, TX 78229-1116
(210) 253-9947
Taxonomy
Speciality
Code
Description
License number
State
208U00000X
Clinical Pharmacology Physician
Primary
N2069
TX
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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