Healthcare Provider Details

I. General information

NPI: 1568281954
Provider Name (Legal Business Name): STAR WEIGHTLOSS AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 10/03/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20770 US HIGHWAY 281 N STE 108-143
SAN ANTONIO TX
78258-7655
US

IV. Provider business mailing address

20770 US HIGHWAY 281 N STE 108-143
SAN ANTONIO TX
78258-7655
US

V. Phone/Fax

Practice location:
  • Phone: 210-880-4479
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NWANDO OKAFOR
Title or Position: PARTNER
Credential: MD
Phone: 210-880-4479