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General NPI Number Information
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NPI Number | 1700208881
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Entity Type | Organization
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Legal Business Name | HEALTH SMART WEIGHT LOSS, LLC
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 600 MEDICAL DR STE 216
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City | WENTZVILLE
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State | MO
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Zip | 63385-3426
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Country | US
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Telephone | 314-603-7332
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Fax |
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Provider Business Mailing Address
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Address Line | 600 MEDICAL DR STE 216
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City | WENTZVILLE
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State | MO
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Zip | 63385-3426
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Country | US
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Telephone | 314-603-7332
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL ALEXANDER TAPIA
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Credential | MD
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Telephone | 636-333-1614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 100712
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License Number State | MO
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