MEDICARE: DR. WENDY AILENE SYMONS D.O.

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	007333	AZ
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	P5573	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	007333	OTHER	AZ	STATE LICENSE

General Provider Information

NPI Number	:	1558505024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY AILENE SYMONS D.O.

Provider Business Mailing Address
First Line	:	6918 CAMP BULLIS RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2236
Country	:	US
Telephone Number	:	210-617-4445
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 E SAUNDERS ST
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-5474
Country	:	US
Telephone Number	:	210-617-4445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/10/2026

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