Basic Information
Provider Information
NPI: 1881072171
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEE
FirstName: SASHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 315 N SAN SABA STE 1135
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782073255
CountryCode: US
TelephoneNumber: 2107043030
FaxNumber:  
Practice Location
Address1: 333 N SANTA ROSA ST
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782073108
CountryCode: US
TelephoneNumber: 2107042011
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/07/2015
LastUpdateDate: 01/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XTRN 21170FLN Allopathic & Osteopathic PhysiciansPediatrics 
208000000X52112SCN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XS6972TXY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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