| |
17655 Henderson Pass Apt 816, San Antonio, TX 78232-1547 | |
(956) 763-7767 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner - Family |
Location | 17655 Henderson Pass Apt 816, San Antonio, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225431091 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 5449 (Texas) | Secondary |
363LF0000X | Nurse Practitioner - Family | F0914439 (Texas) | Primary |
Mailing Address | Practice Location Address |
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17655 Henderson Pass Apt 816, San Antonio, TX 78232-1547 Ph: (956) 763-7767 | 17655 Henderson Pass Apt 816, San Antonio, TX 78232-1547 Ph: (956) 763-7767 |