Individual
DR. NICHOLE JEANETTA VAN DE PUTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1102 BARCLAY ST, SAN ANTONIO, TX 78207-7161
(210) 233-7000
(210) 434-1704
Mailing address
3066 E COMMERCE ST, SAN ANTONIO, TX 78220-1013
(210) 233-7000
(210) 277-6387
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
P2555
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301049802
—
TX
Enumeration date
06/10/2008
Last updated
08/04/2017
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