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Individual

ALEXIS ANN WIESENTHAL MILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
333 W OLMOS DR #18, SAN ANTONIO, TX 78212
(210) 614-1010
(210) 949-1010
Mailing address
PO BOX 6627, SAN ANTONIO, TX 78209
(210) 614-1010
(210) 949-1010

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36165
AZ
207R00000X
Internal Medicine Physician
A103118
CA
207R00000X
Internal Medicine Physician
Primary
N1219
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
219490401
TX
Enumeration date
03/15/2006
Last updated
02/28/2025
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