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General NPI Number Information
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NPI Number | 1417007006
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Entity Type | Individual
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Provider Name | JON THOMAS PELZL M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 8042 WURZBACH RD STE 310
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-614-5113
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Fax | 210-616-0024
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Provider Business Mailing Address
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Address Line | 8042 WURZBACH RD STE 310
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3807
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Country | US
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Telephone | 210-614-5113
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Fax | 210-616-0024
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 24524
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License Number State | OK
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