Provider Demographics
NPI:1790012276
Name:JENNINGS, WILLIAM PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PATRICK
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8122 DATAPOINT DR
Mailing Address - Street 2:SUITE1010
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3272
Mailing Address - Country:US
Mailing Address - Phone:210-614-7483
Mailing Address - Fax:210-614-8351
Practice Address - Street 1:8122 DATAPOINT DR
Practice Address - Street 2:SUITE 1010
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3272
Practice Address - Country:US
Practice Address - Phone:210-614-7483
Practice Address - Fax:210-614-8351
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG4316207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE38839Medicare UPIN