Basic Information
| Provider Information | |||||||||
| NPI: | 1629099247 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DIABETES AND METABOLISM SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4118 POND HILL RD | ||||||||
| Address2: | BUILDING 3 | ||||||||
| City: | SHAVANO PARK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782311281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104943739 | ||||||||
| FaxNumber: | 2104944508 | ||||||||
| Practice Location | |||||||||
| Address1: | 4118 POND HILL RD | ||||||||
| Address2: | BUILDING 3 | ||||||||
| City: | SHAVANO PARK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782311281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104943739 | ||||||||
| FaxNumber: | 2104944508 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 03/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | WELCH | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | M.D. | ||||||||
| AuthorizedOfficialTelephone: | 2104943739 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.