MEDICARE: DR. TAMRE B MCCLELLAND M.D.

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	207Q00000X	Family Medicine Physician	H6419	TX

General Provider Information

NPI Number	:	1871601385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMRE B MCCLELLAND M.D.

Provider Business Mailing Address
First Line	:	2961 MOSSROCK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5119
Country	:	US
Telephone Number	:	210-731-4800
Fax Number	:	210-731-4810

Provider Business Practice Location Address
First Line	:	8906 PERRIN BEITEL RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217
Country	:	US
Telephone Number	:	210-572-3306
Fax Number	:	210-249-0125

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/24/2019

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