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General NPI Number Information
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NPI Number | 1174722383
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Entity Type | Individual
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Provider Name | MEGAN ROSE-LEE WILLIAMS KHMELEV MD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 6496 N NEW BRAUNFELS AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78209-3827
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Country | US
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Telephone | 210-930-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 9150 HUEBNER RD STE 160
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1545
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Country | US
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Telephone | 210-960-2639
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Fax | 210-845-1832
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N1222
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP1-0029850
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License Number State | TX
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