Individual
THERESA FANASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
63 CHAMPIONS RUN, SAN ANTONIO, TX 78258-7703
(409) 554-2645
Mailing address
63 CHAMPIONS RUN, SAN ANTONIO, TX 78258-7703
(409) 554-2645
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1057198
TX
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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