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NPI Code Detail

MEDICARE: LORALYN WAFFUL PA-C

MEDICARE: LORALYN WAFFUL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDT84288TX
2363AM0700XMedical Physician AssistantPA16989TX

General Provider Information

NPI Number : 1316497985
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORALYN WAFFUL PA-C
Provider Business Mailing Address
First Line : 3320 OAKWELL CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-3128
Country : US
Telephone Number : 210-829-5180
Fax Number :
Provider Business Practice Location Address
First Line : 3320 OAKWELL CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-3128
Country : US
Telephone Number : 210-829-5180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2016
Last Update Date : 07/01/2024

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Directions to “ LORALYN WAFFUL PA-C” Practice Location

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