Individual
MR. JUSTIN VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2515 CASTROVILLE RD, SAN ANTONIO, TX 78237-3359
(210) 433-0366
Mailing address
2515 CASTROVILLE RD, SAN ANTONIO, TX 78237-3359
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP138238
TX
Other
Enumeration date
01/02/2019
Last updated
05/06/2025
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