NPIMap

Organization Active NPI

San Antonio Weightloss LLC

Doing business as Medi Weightloss Clinic San Antonio

  • Obesity Medicine (Family Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1609230721
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
Legal business name
SAN ANTONIO WEIGHTLOSS LLC
Doing business as
Medi Weightloss Clinic San Antonio
Practice address
11703 Huebner Rd
Suite 100
San Antonio, TX 78230-1201
Phone
(210) 697-9500
NPI assigned
Apr 6, 2016
Last updated
Apr 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Authorized official

Name
Thomas K Willett
Title
Managing Member
Phone
(813) 225-1051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Family Medicine) Physician 207QB0002X Primary

Addresses

Primary practice location

11703 Huebner Rd
Suite 100
San Antonio, TX 78230-1201

Mailing address

412 E Madison St
Suite 1100
Tampa, FL 33602-4601

Other names 1

  • Medi Weightloss Clinic San Antonio Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medi Weightloss Clinic San Antonio2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1609230721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E MADISON ST",
            "address_2": "SUITE 1100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 HUEBNER RD",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301201",
            "telephone_number": "210-697-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO WEIGHTLOSS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "WILLETT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "813-225-1051"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi Weightloss Clinic San Antonio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 6, 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.