Individual
IRA JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
16620 SAN PEDRO AVE STE 300, SAN ANTONIO, TX 78232-2679
(210) 309-1405
Mailing address
6730 ALAN HALE ST, SAN ANTONIO, TX 78240-2401
(484) 725-7143
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP145287
TX
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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