Provider Type Icon

NACOGDOCHES FAMILY CLINIC LLC NPI 1942803341


NPI Information

NPI: 1942803341
Provider Name: NACOGDOCHES FAMILY CLINIC LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 45D2200583

Address:
12521 NACOGDOCHES RD STE 101
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 634-7814
Get Directions

NACOGDOCHES FAMILY CLINIC LLC is a family nurse practitioner in San Antonio, TX. NACOGDOCHES FAMILY CLINIC LLC NPI is 1942803341. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12521 NACOGDOCHES RD STE 101
SAN ANTONIO, TX
ZIP 78217-117
Phone: (210) 634-7814
Fax: (210) 634-7815

The provider's authorized official is Yordanis Rafael Fonseca Vega .
The authorized official title is Owner and has the following contact phone number (512) 909-7332.

The CLIA number assigned to this NPI record is 45D2200583 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/18/2020 and was last updated on 11/18/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.