Organization
MOUNGER NP FIRST ASSIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILMER KYLE MOUNGER AGACNP (OWNER)
(973) 865-2944
Entity
Organization
Contact information
Practice address
12014 FORT LEATON, SAN ANTONIO, TX 78254-6363
(973) 865-2944
Mailing address
12014 FORT LEATON, SAN ANTONIO, TX 78254-6363
(973) 865-2944
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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