Organization Active NPI

Drwlc1

  • Obesity Medicine (Family Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1710364708
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
License
L3099 Issued in TX
Legal business name
DRWLC1
Practice address
5539 N W Loop 1604
Suite 104
San Antonio, TX 78253-1708
Phone
(210) 495-2117
Fax
(888) 893-4363
NPI assigned
Apr 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Tamyra L Rogers, M.D.
Title
Owner
Phone
(210) 495-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QB0002X L3099 TX Primary

Addresses

Primary practice location

5539 N W Loop 1604
Suite 104
San Antonio, TX 78253-1708

Mailing address

2815 N Loop 1604 E
Suite 105
San Antonio, TX 78232-1708
Phone (210) 495-2117

National Provider Directory

National Provider Directory

Locations

5539 W Loop 1604 N
Ste 104
San Antonio, TX 78253
Phone (210) 495-2117

2815 N Loop 1604 E
Ste 105
San Antonio, TX 78232
Phone (210) 495-2117

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1710364708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 N LOOP 1604 E",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321708",
            "telephone_number": "210-495-2117",
            "fax_number": "888-893-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5539 N W LOOP 1604",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782531708",
            "telephone_number": "210-495-2117",
            "fax_number": "888-893-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRWLC1",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "TAMYRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-495-2117",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "TX",
            "license": "L3099",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 29, 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.