Healthcare Provider Details

I. General information

NPI: 1386948677
Provider Name (Legal Business Name): WELLMED NETWORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2010
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7622 LOUIS PASTEUR SUITE 100
SAN ANTONIO TX
78229-4019
US

IV. Provider business mailing address

19500 IH-10W, MS1-5030 ATTN: LICENSING & REGULATORY
SAN ANTONIO TX
78257-1219
US

V. Phone/Fax

Practice location:
  • Phone: 210-588-0122
  • Fax: 210-588-0120
Mailing address:
  • Phone: 210-617-4706
  • Fax: 210-641-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH ZIMMERMAN
Title or Position: SECRETARY
Credential:
Phone: 210-617-4706