Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R2599 | TX |
N | 111NI0900X | Internist | R2599 | TX |
N | 207RG0300X | Geriatric Medicine | 052727 | CT |
Y | 207RG0300X | Geriatric Medicine | R2599 | TX |
NPI | 1053699884 |
---|---|
Provider Name | Cynthia Gneco Wilamo |
First Address | San Antonio, TX 78230-5119 |
Second Address | San Antonio, TX 78228-6299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2011 |
Last Update Date | 16/10/2020 |