Dr David S Wise PA

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

H8963 Issued in TX

Legal business name

DR DAVID S WISE PA

Practice address

11606 Mill Rock Rd
San Antonio, TX 78230-2762

Phone

(210) 258-5009

NPI assigned

Nov 8, 2016

Organization subpart

No

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

Authorized official

Name

Dr. David S Wise, M.D.

Title

President

Phone

(210) 258-5009

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1376085282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460625",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782460625",
            "telephone_number": "210-258-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11606 MILL ROCK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302762",
            "telephone_number": "210-258-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DAVID S WISE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-258-5009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TX",
            "license": "H8963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000204D8",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Point of Service in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.