Provider Demographics
NPI:1386948677
Name:WELLMED NETWORKS, INC.
Entity type:Organization
Organization Name:WELLMED NETWORKS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-617-4706
Mailing Address - Street 1:19500 IH-10W, MS1-5030
Mailing Address - Street 2:ATTN: LICENSING & REGULATORY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1219
Mailing Address - Country:US
Mailing Address - Phone:210-617-4706
Mailing Address - Fax:210-641-2235
Practice Address - Street 1:7622 LOUIS PASTEUR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4019
Practice Address - Country:US
Practice Address - Phone:210-588-0122
Practice Address - Fax:210-588-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-31
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB123764Medicare UPIN