Provider Demographics
NPI:1356762223
Name:RWPK PLLC
Entity type:Organization
Organization Name:RWPK PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:REX
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILDEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-417-4181
Mailing Address - Street 1:10003 NW MILITARY HWY STE 3201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1892
Mailing Address - Country:US
Mailing Address - Phone:210-417-4181
Mailing Address - Fax:210-417-4181
Practice Address - Street 1:10003 NW MILITARY HWY STE 3201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1892
Practice Address - Country:US
Practice Address - Phone:210-417-4181
Practice Address - Fax:210-417-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty