Individual
JUDITH COLVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
527 N LEONA ST, SAN ANTONIO, TX 78207-3110
(210) 358-5921
Mailing address
527 N LEONA ST, SAN ANTONIO, TX 78207-3110
(210) 358-5921
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01640
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202102401
—
TX
01
—
970012347
MEDICARE RR
TX
Enumeration date
08/15/2006
Last updated
07/27/2010
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