Individual
MICHAEL PEQUENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
1200 BROOKLYN AVE, SAN ANTONIO, TX 78212-4803
(210) 281-9800
(210) 281-1001
Mailing address
1200 BROOKLYN AVE, SAN ANTONIO, TX 78212-4803
(210) 281-9800
(210) 281-1001
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
AP136257
TX
363L00000X
Nurse Practitioner
Primary
AP136257
TX
363LA2100X
Acute Care Nurse Practitioner
AP136257
TX
Other
Enumeration date
06/06/2018
Last updated
02/29/2024
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