Provider Demographics
NPI:1245453307
Name:WIEMERS, MARCY R (MD)
Entity type:Individual
Prefix:DR
First Name:MARCY
Middle Name:R
Last Name:WIEMERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:
Practice Address - Street 1:1831 S GENERAL MCMULLEN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78226-1190
Practice Address - Country:US
Practice Address - Phone:210-644-8500
Practice Address - Fax:210-644-8526
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM0308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BJ990OtherBCBS
TX188670703Medicaid
TX8BJ990OtherBCBS