Individual
LAURA JEAN WILNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
Mailing address
315 N SAN SABA STE 1135, SAN ANTONIO, TX 78207-3255
(210) 704-4275
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
U9187
TX
2081P0010X
Pediatric Rehabilitation Medicine Physician
51885
AZ
2081P0010X
Pediatric Rehabilitation Medicine Physician
ME111475
FL
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
U9187
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004522600
—
FL
01
—
FW586Z
MEDICARE PTAN
FL
Enumeration date
12/07/2005
Last updated
03/08/2024
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