Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 14062 | TX |
Y | 213EG0000X | General Practice | 14062 | TX |
NPI | 1003825993 |
---|---|
Provider Name | Dr. Robbie Wayne Henwood |
First Address | San Antonio, TX 78238-2338 |
Second Address | San Antonio, TX 78250-3089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 08/07/2007 |