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Individual

DR. MATTHEW WILLIAM WAACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
12406 STABLE FOREST DR, SAN ANTONIO, TX 78249-4614
(210) 690-5296
(210) 690-5296
Mailing address
12406 STABLE FOREST DR, SAN ANTONIO, TX 78249-4614
(210) 690-5296
(210) 690-5296

Taxonomy

Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
2065
OK
2083A0100X
Aerospace Medicine Physician
Primary
K9928
TX

Other

Enumeration date
06/25/2007
Last updated
07/08/2007
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