Individual
BRIAN BERNARD LUPFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
221 3RD ST W, 12 MEDICAL GROUP BLDG 1040, RANDOLPH AFB, TX 78150-4800
(210) 652-2117
(210) 652-7128
Mailing address
221 3RD ST W, 12 MEDICAL GROUP BLDG 1040, RANDOLPH AFB, TX 78150-4800
(210) 652-2117
(210) 652-7128
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1058972
NCC PA
—
Enumeration date
02/06/2006
Last updated
03/12/2009
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