Individual
CHELISA MARTINEZ DE LA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8600 WURZBACH RD STE 700, SAN ANTONIO, TX 78240-4332
(210) 737-8090
Mailing address
502 1/2 CROUCH AVE, DEVINE, TX 78016-2026
(210) 330-4955
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
345773
TX
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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