Individual
MS. DENISE VEGA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, GNP-BC, ACNP-BC
Contact information
Practice address
4411 MEDICAL DR, SUITE 300, SAN ANTONIO, TX 78229-3822
(210) 614-5400
(210) 614-2413
Mailing address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-2413
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
649365
TX
363LA2100X
Acute Care Nurse Practitioner
649365
TX
363LG0600X
Gerontology Nurse Practitioner
649365
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342347701
—
TX
01
—
381801YR99
MEDICARE
TX
01
—
8095NM
BCBS TX
TX
01
—
P01432253
RR MEDICARE
TX
Enumeration date
05/19/2010
Last updated
07/26/2019
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