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Organization
NACOGDOCHES FAMILY CLINIC LLC
Active
Organization
NACOGDOCHES FAMILY CLINIC LLC
Active
Other names
CLINICA FAMILIAR NACOGDOCHES
Organization subpart
No
Provider details
NPI number
Authorized official
YORDANIS RAFAEL FONSECA VEGA APRN, FNP-C (OWNER)
(512) 909-7332
Entity
Organization
Contact information
Practice address
12521 NACOGDOCHES RD STE 101, SAN ANTONIO, TX 78217-2117
(210) 634-7814
(210) 634-7815
Mailing address
12521 NACOGDOCHES RD STE 101, SAN ANTONIO, TX 78217-2117
(210) 634-7814
(210) 634-7815
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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