Organization Active NPI

Martin J. Wiesenthal, MD, PA

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1013165356
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E4763 Issued in TX
Legal business name
MARTIN J. WIESENTHAL, MD, PA
Practice address
8038 Wurzbach Rd
Suite 320
San Antonio, TX 78229-3817
Phone
(210) 614-3365
Fax
(210) 615-3757
NPI assigned
Aug 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Martin J. Wiesenthal, M.D.
Title
President
Phone
(210) 614-3365

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X E4763 TX Primary

Addresses

Primary practice location

8038 Wurzbach Rd
Suite 320
San Antonio, TX 78229-3817

Mailing address

PO Box 66
San Antonio, TX 78291-0066

Other identifiers 1

IdentifierTypeStateIssuer
219489601MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1013165356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8038 WURZBACH RD",
            "address_2": "SUITE 320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293817",
            "telephone_number": "210-614-3365",
            "fax_number": "210-615-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN J. WIESENTHAL, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "WIESENTHAL",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-614-3365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E4763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219489601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.