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General NPI Number Information
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NPI Number | 1578510095
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Entity Type | Organization
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Legal Business Name | DENNIS E. WILLIS, M.D., P.A..
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Dates
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Enumeration Date | 05/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8711 VILLAGE DR SUITE # 325
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5418
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Country | US
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Telephone | 210-590-6900
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Fax | 210-590-6907
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Provider Business Mailing Address
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Address Line | PO BOX 171125
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City | SAN ANTONIO
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State | TX
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Zip | 78217-8125
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Country | US
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Telephone | 210-590-6900
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Fax | 210-590-6907
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS E. WILLIS
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Credential |
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Telephone | 210-590-6900
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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 | K7950
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License Number State | TX
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