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General NPI Number Information
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NPI Number | 1760773519
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Entity Type | Organization
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Legal Business Name | BRYAN J. WOHLFELD, M.D., P.A.
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 4410 MEDICAL DR SUITE 600
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City | SAN ANTONIO
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State | TX
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Zip | 78229-6306
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Country | US
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Telephone | 210-615-5200
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Fax | 210-615-5206
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Provider Business Mailing Address
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Address Line | 4410 MEDICAL DR SUITE 600
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City | SAN ANTONIO
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State | TX
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Zip | 78229-6306
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Country | US
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Telephone | 210-615-5200
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Fax | 210-615-5206
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRYAN J. WOHLFELD
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Credential | M.D.
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Telephone | 214-284-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | N7764
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License Number State | TX
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