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General NPI Number Information
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NPI Number | 1831694579
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Entity Type | Individual
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Provider Name | ALEXANDRA WYNN MD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1248 AUSTIN HWY STE 214
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City | SAN ANTONIO
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State | TX
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Zip | 78209-4867
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Country | US
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Telephone | 210-828-2531
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Fax | 210-828-2532
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Provider Business Mailing Address
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Address Line | 2961 MOSSROCK
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City | SAN ANTONIO
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State | TX
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Zip | 78230-5119
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Country | US
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Telephone | 210-731-4800
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Fax | 210-731-4810
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | S9439
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License Number State | TX
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