Waller, Stephen Glenn
Waller, Stephen Glenn is an individual health care provider with primary practice located at 2200 Bergquist Dr Suite 1, Lackland A F B TX 78236-9907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Waller, Stephen Glenn can be contacted via phone (210) 292-6583.Contact Information
Primary practice address
2200 Bergquist Dr Suite 1
Lackland A F B TX 78236-9907
Phone: (210) 292-6583
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | M0303 | Texas |
Profile Details
| NPI number | 1629057609 |
|---|---|
| LBN Legal business name | Waller, Stephen Glenn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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