Organization
HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC
Active
Organization
HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERI L PENKAVA MD (SOLE OWNER)
(210) 403-2343
Entity
Organization
Contact information
Practice address
4940 BROADWAY STE 100, SAN ANTONIO, TX 78209-5732
(210) 403-2343
(210) 403-2350
Mailing address
4940 BROADWAY STE 100, SAN ANTONIO, TX 78209-5732
(210) 403-2343
(210) 403-2350
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
202D00000X
Integrative Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520125301
—
TX
Enumeration date
12/07/2024
Last updated
05/11/2026
Update your record
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