| Central Texas Diabetes & Wellness Institute | |
|
5441 Babcock Rd Ste 203 San Antonio TX 78240-3993 | |
| (210) 701-8890 | |
| (210) 783-8840 |
| Full Name | Central Texas Diabetes & Wellness Institute |
|---|---|
| Speciality | Internal Medicine |
| Location | 5441 Babcock Rd Ste 203, San Antonio, Texas |
| Authorized Official Name and Position | Jarra Green-calderon (OWNER) |
| Authorized Official Contact | 8325600254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Texas Diabetes & Wellness Institute 8428 Bandera Rd Ste 2 San Antonio TX 78250-2514 Ph: () - | Central Texas Diabetes & Wellness Institute 5441 Babcock Rd Ste 203 San Antonio TX 78240-3993 Ph: (210) 701-8890 |
| NPI Number | 1356951735 |
|---|---|
| Provider Enumeration Date | 07/31/2020 |
| Last Update Date | 08/30/2024 |
| Medicare PECOS PAC ID | 5496165607 |
|---|---|
| Medicare Enrollment ID | O20201029000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356951735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Jarra L Green-calderon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659516615 PECOS PAC ID: 6305256512 Enrollment ID: I20201029000616 |
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