Individual
DR. GREGG LOREN WENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5223 HAMILTON WOLFE RD, SAN ANTONIO, TX 78229-4463
(210) 614-1234
(210) 614-0952
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2213
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
S1538
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100308920
—
KY
01
—
S1538
TEXAS STATE LICENSE
TX
Enumeration date
05/14/2013
Last updated
07/06/2021
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