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General NPI Number Information
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NPI Number | 1063799567
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Entity Type | Organization
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Legal Business Name | HEART & VASCULAR CLINIC OF SAN ANTONIO, PLLC
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 927 MCCULLOUGH AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1630
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Country | US
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Telephone | 210-223-6896
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Fax | 210-223-3888
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Provider Business Mailing Address
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Address Line | 927 MCCULLOUGH AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1630
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Country | US
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Telephone | 210-223-6896
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Fax | 210-223-3888
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. WILLIAM C.L. WU
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Credential | M.D.
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Telephone | 210-223-6896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | H 8897
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License Number State | TX
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