Individual
ALYSSA SHANNON BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
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
363A00000X
Physician Assistant
Primary
PA18258
TX
363AM0700X
Medical Physician Assistant
027233
NY
363AM0700X
Medical Physician Assistant
MA062138
PA
Other
Enumeration date
11/16/2020
Last updated
10/30/2024
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