Healthcare Provider Details

I. General information

NPI: 1073438347
Provider Name (Legal Business Name): ISIS MONK
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25010 ESTANCIA CIR
SAN ANTONIO TX
78260-4346
US

IV. Provider business mailing address

25010 ESTANCIA CIR
SAN ANTONIO TX
78260-4346
US

V. Phone/Fax

Practice location:
  • Phone: 872-772-9571
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1033021
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: