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NPI Code Detail

MEDICARE: ANAIS ADRIANA TRISTAN

MEDICARE: ANAIS ADRIANA TRISTAN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1972181360
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANAIS ADRIANA TRISTAN
Provider Business Mailing Address
First Line : 523 LIVELY DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78213-2810
Country : US
Telephone Number : 210-730-4036
Fax Number :
Provider Business Practice Location Address
First Line : 703 E HILDEBRAND AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-2535
Country : US
Telephone Number : 210-883-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2021
Last Update Date : 03/29/2021

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Directions to “ ANAIS ADRIANA TRISTAN ” Practice Location

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