Provider Demographics
NPI:1073906566
Name:WEHNER, ROBERT (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WEHNER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14615 SAN PERDO
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4364
Mailing Address - Country:US
Mailing Address - Phone:210-404-0020
Mailing Address - Fax:210-403-9545
Practice Address - Street 1:14615 SAN PERDO
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4364
Practice Address - Country:US
Practice Address - Phone:210-404-0020
Practice Address - Fax:210-403-9545
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX561300367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX561300OtherNURSE ANESTHETIST
TX561300OtherRN LIC