Provider Demographics
NPI:1710032784
Name:WETZ, ROBERT R (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:WETZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1583 THOUSAND OAKS DR
Mailing Address - Street 2:SUITE #127
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2300
Mailing Address - Country:US
Mailing Address - Phone:210-545-2225
Mailing Address - Fax:210-545-2254
Practice Address - Street 1:1583 THOUSAND OAKS DR
Practice Address - Street 2:SUITE #127
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2300
Practice Address - Country:US
Practice Address - Phone:210-545-2225
Practice Address - Fax:210-545-2254
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603794OtherBCBSTX
TX603794OtherBCBSTX