Individual
WALTER MITINI ETOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
(210) 358-0647
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
(210) 358-0647
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1014388
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1014388
TX
363LA2100X
Acute Care Nurse Practitioner
4704258160
MI
Other
Enumeration date
07/30/2019
Last updated
03/14/2023
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