Elemental Weight Loss Clinic

Primary specialty

Obesity Medicine (Preventive Medicine) PhysicianTaxonomy code 2083B0002X

Legal business name

ELEMENTAL WEIGHT LOSS CLINIC

Practice address

9150 Huebner Rd
Ste 160
San Antonio, TX 78240-1558

Phone

(210) 960-2639

Fax

(210) 845-1832

NPI assigned

Jun 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Megan Rose-Lee Williams Khmelev, MD

Title

President

Phone

(210) 960-2639

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1285084939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 HUEBNER RD",
            "address_2": "STE 160",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401558",
            "telephone_number": "210-960-2639",
            "fax_number": "210-845-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 HUEBNER RD",
            "address_2": "STE 160",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401558",
            "telephone_number": "210-960-2639",
            "fax_number": "210-845-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTAL WEIGHT LOSS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS KHMELEV",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "ROSE-LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-960-2639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "N1222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obesity Medicine (Preventive Medicine) Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Obesity Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.