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Individual

JOHN PAUL NIETO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
510 MED CT STE 210, SAN ANTONIO, TX 78258-3484
(210) 494-4290
(210) 494-4809
Mailing address
510 MED CT STE 210, SAN ANTONIO, TX 78258-3484
(210) 494-4290
(210) 494-4809

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12192
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA12192
STATE LICENSE
TX
Enumeration date
08/07/2018
Last updated
07/26/2024
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