Provider Demographics
NPI:1689733495
Name:JENNINGS, WES
Entity Type:Individual
Prefix:MR
First Name:WES
Middle Name:
Last Name:JENNINGS
Suffix:
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 1:16601 BLANCO RD
Mailing Address - Street 2:#207
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1914
Mailing Address - Country:US
Mailing Address - Phone:210-823-7056
Mailing Address - Fax:
Practice Address - Street 1:16601 BLANCO RD
Practice Address - Street 2:#207
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1914
Practice Address - Country:US
Practice Address - Phone:210-823-7056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography