Individual
COLLINS O IDIEGBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
4411 MEDICAL DR, 300, SAN ANTONIO, TX 78229-3822
(210) 614-5400
(210) 614-5732
Mailing address
4411 MEDICAL DR, 300, SAN ANTONIO, TX 78229-3822
(210) 614-5400
(210) 614-5732
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
751397
TX
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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