DR. Stephen Glenn Waller, MD

NPI #1629057609 in Lackland a F B, Texas

Provider Information

NPI Number: 1629057609
Entity Type: Individual
Name: DR. Stephen Glenn Waller, MD
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Ophthalmology
Credential: MD
Enumeration Date: Jan 10, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2200 BERGQUIST DR
Address 2: SUITE 1
City: Lackland a F B
State: Texas
ZIP Code: 78236-9907
Phone: (210) 292-6583

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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