Provider Demographics
NPI:1427636422
Name:WARE, JOHN J JR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:WARE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 N LOOP 1604 W APT 1721
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2774
Mailing Address - Country:US
Mailing Address - Phone:313-205-6134
Mailing Address - Fax:
Practice Address - Street 1:8910 N LOOP 1604 W APT 1721
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2774
Practice Address - Country:US
Practice Address - Phone:313-205-6134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports