Individual
IVANNA ELIZABETH SAUCEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3320 OAKWELL CT, SAN ANTONIO, TX 78218-3019
(210) 829-5180
Mailing address
3320 OAKWELL CT, SAN ANTONIO, TX 78218-3128
(210) 829-5180
(210) 314-8315
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10737
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376912701
—
TX
01
—
PA10737
TEXAS LICENSE
TX
Enumeration date
08/23/2016
Last updated
03/06/2026
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