| NPI | 1588922561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN D. WELLS President 210-347-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-05-01 |