# MOUNGER NP FIRST ASSIST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073162160
- **Authorized official:** WILMER KYLE MOUNGER AGACNP (OWNER)
- **Authorized official phone:** (973) 865-2944

## Contact information

- **Practice address:** 12014 FORT LEATON, SAN ANTONIO, TX 78254-6363
- **Practice address phone:** (973) 865-2944
- **Mailing address:** 12014 FORT LEATON, SAN ANTONIO, TX 78254-6363
- **Mailing address phone:** (973) 865-2944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2019
- **Last updated:** 09/10/2019