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NPI Code Detail

MEDICARE: RYAN MARK WOHLRABE P.A.

MEDICARE: RYAN MARK WOHLRABE P.A.
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1710313135
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN MARK WOHLRABE P.A.
Provider Business Mailing Address
First Line : 4511 HORIZON HILL BLVD STE 150
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-2449
Country : US
Telephone Number : 210-477-2626
Fax Number : 210-477-2650
Provider Business Practice Location Address
First Line : 4511 HORIZON HILL BLVD STE 150
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-2449
Country : US
Telephone Number : 210-477-2626
Fax Number : 210-477-2650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2013
Last Update Date : 08/04/2022

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