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NPI Code Detail

MEDICARE: MIWA MEDICAL GROUP, PLLC

MEDICARE: MIWA MEDICAL GROUP, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianN7147TX

General Provider Information

NPI Number : 1326323056
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIWA MEDICAL GROUP, PLLC
Provider Business Mailing Address
First Line : PO BOX 6818
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-0818
Country : US
Telephone Number : 830-309-8621
Fax Number :
Provider Business Practice Location Address
First Line : 600 DIVISION AVE STE G
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78214-1336
Country : US
Telephone Number : 210-259-8088
Fax Number : 210-265-1142
Authorized Official
Title or Position : OWNER
Name : DR. EDWARD A MIWA
Credential : M.D
Telephone Number : 210-391-8400
Provider Enumeration Date : 10/13/2011
Last Update Date : 06/17/2019

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Directions to “MIWA MEDICAL GROUP, PLLC ” Practice Location

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