Healthcare Provider Details

I. General information

NPI: 1831109636
Provider Name (Legal Business Name): WAJEH QUNIBI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US

IV. Provider business mailing address

7703 FLOYD CURL DR MC7977
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 210-257-1400
  • Fax: 210-257-1428
Mailing address:
  • Phone: 210-257-1400
  • Fax: 210-257-1428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberF0629
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: