Healthcare Provider Details

I. General information

NPI: 1497328595
Provider Name (Legal Business Name): MINDY DIANE POSTERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CULLY DR
KERRVILLE TX
78028-5950
US

IV. Provider business mailing address

385 ARENA RD
BANDERA TX
78003-3962
US

V. Phone/Fax

Practice location:
  • Phone: 830-258-6300
  • Fax: 830-515-5485
Mailing address:
  • Phone: 817-564-5269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1047787
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1047787
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1047787
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: