Individual
CORA LEAH DZIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, NP-C
Contact information
Practice address
448 CASTROVILLE RD, SAN ANTONIO, TX 78207-5147
(210) 434-1400
(210) 431-7472
Mailing address
448 CASTROVILLE RD, SAN ANTONIO, TX 78207-5147
(210) 434-1400
(210) 431-7472
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
669986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122502308
CAQH
TX
01
—
261129YL9S
WELLMED MEDICAL GROUP PA
TX
01
—
313361301
WELLMED MEDICAID
TX
Enumeration date
11/04/2010
Last updated
01/28/2019
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