Individual
MARK WENGROVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9153 HUEBNER RD., SAN ANTONIO, TX 78240-1502
(210) 614-7414
(210) 616-0509
Mailing address
5047 SHERRI ANN RD, SAN ANTONIO, TX 78233-6213
(210) 237-4444
(210) 828-5731
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
J7246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117279301
—
TX
Enumeration date
06/20/2005
Last updated
06/02/2022
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