Provider Demographics
NPI:1417007006
Name:PELZL, JON THOMAS (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:THOMAS
Last Name:PELZL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8042 WURZBACH RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3807
Mailing Address - Country:US
Mailing Address - Phone:210-614-5113
Mailing Address - Fax:210-616-0024
Practice Address - Street 1:8042 WURZBACH RD STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-614-5113
Practice Address - Fax:210-616-0024
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2018-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK24524208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery