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TIM SENTHAVISOUK NP NPI 1376731885


NPI Information

NPI: 1376731885
Provider Name: TIM SENTHAVISOUK, NP
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual
Address:
4800 FREDERICKSBURG RD
SUITE 127
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 733-5072
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Tim Senthavisouk, NP is a nurse practitioner in San Antonio, TX. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Tim Senthavisouk, NP NPI is 1376731885. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4800 FREDERICKSBURG RD
SUITE 127
SAN ANTONIO, TX
ZIP 78229-628
Phone: (210) 733-5072
Fax: (210) 733-8649

The enumeration date for this NPI number is 10/9/2007 and was last updated on 5/5/2014.


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 PractitionerFamilyNP 16316CALIFORNIANo
2363LF0000XNurse PractitionerFamily775309TEXASNo
3363L00000XNurse Practitioner775309TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10930196740MEDICARE OSCAR/CERTIFICATIONCALIFORNIA
20930196740MEDICARE NSCCALIFORNIA
30930196740MEDICARE UPINCALIFORNIA
40930196740MEDICAIDCALIFORNIA
50930196740MEDICARE PINCALIFORNIA

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

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