Michael N Wall, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G1227 Issued in TX

Legal business name

MICHAEL N WALL, MD

Practice address

4085 De Zavala Rd
Suite 200
Shavano Park, TX 78249-2084

Phone

(210) 558-6288

Fax

(210) 558-6289

NPI assigned

Jul 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael N Wall, MD

Title

President

Phone

(210) 558-6288

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1063678894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1606",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782961606",
            "telephone_number": "210-558-6299",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD",
            "address_2": "SUITE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL N WALL, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-558-6288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "G1227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035387201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel McMillian, CNIM
• Diane E McPhail, MS, CCC/SLP
• Lori Medina-Ibarra, OT
• Shakil H Merchant, M.D.
• John D Metter, M.D.
• Thomas Joseph Molnar, LCSW
• Marysa D. Mumphrey, D.O.
• Naumit S. Bhandari P.a.
• NCHR
• Lizet Nelms

• Nephrology Physician in Shavano Park, TX
• Providers in Shavano Park, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.