Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | E4196 | TX |
NPI | 1578655130 |
---|---|
Provider Name | Dr. Wassel Holland Beal |
First Address | San Antonio, TX 78240-3134 |
Second Address | San Antonio, TX 78229-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |