MEDICARE: DIABETES AND METABOLISM SPECIALISTS

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1629099247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIABETES AND METABOLISM SPECIALISTS

Provider Business Mailing Address
First Line	:	4118 POND HILL RD
Second Line	:	BUILDING 3
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1281
Country	:	US
Telephone Number	:	210-494-3739
Fax Number	:	210-494-4508

Provider Business Practice Location Address
First Line	:	4118 POND HILL RD
Second Line	:	BUILDING 3
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1281
Country	:	US
Telephone Number	:	210-494-3739
Fax Number	:	210-494-4508

Authorized Official
Title or Position	:	M.D.
Name	:	DR. MICHELLE D WELCH
Credential	:
Telephone Number	:	210-494-3739

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	10/02/2024

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