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NPI Code Detail

MEDICARE: MIREYA VANDERSLICE DNP

MEDICARE: MIREYA VANDERSLICE DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner700867TX
2363LF0000XFamily Nurse PractitionerAP114967TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TXB153249OTHERTXWELLMED MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952314213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIREYA VANDERSLICE DNP
Provider Business Mailing Address
First Line : 517 SW MILITARY DR STE 106
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78221-1639
Country : US
Telephone Number : 210-921-0322
Fax Number : 210-921-1451
Provider Business Practice Location Address
First Line : 517 SW MILITARY DR STE 106
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78221-1639
Country : US
Telephone Number : 210-921-0322
Fax Number : 210-921-1451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 09/24/2024

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Directions to “ MIREYA VANDERSLICE DNP” Practice Location

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