Provider Demographics
NPI:1629099247
Name:DIABETES AND METABOLISM SPECIALISTS
Entity Type:Organization
Organization Name:DIABETES AND METABOLISM SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-494-3739
Mailing Address - Street 1:4118 POND HILL RD
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1281
Mailing Address - Country:US
Mailing Address - Phone:210-494-3739
Mailing Address - Fax:210-494-4508
Practice Address - Street 1:4118 POND HILL RD
Practice Address - Street 2:BUILDING 3
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1281
Practice Address - Country:US
Practice Address - Phone:210-494-3739
Practice Address - Fax:210-494-4508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W775Medicare PIN