Provider Demographics
NPI:1841840337
Name:TEFERI, WEZM T
Entity type:Individual
Prefix:MS
First Name:WEZM
Middle Name:T
Last Name:TEFERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8602 CINNAMON CREEK DR APT 1103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1465
Mailing Address - Country:US
Mailing Address - Phone:210-904-6851
Mailing Address - Fax:
Practice Address - Street 1:8602 CINNAMON CREEK DR APT 1103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1465
Practice Address - Country:US
Practice Address - Phone:210-904-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care