Healthcare Provider Details

I. General information

NPI: 1548135379
Provider Name (Legal Business Name): JULIANA MESSINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12602 TOEPPERWEIN RD STE 208
LIVE OAK TX
78233-3271
US

IV. Provider business mailing address

24A 4TH ST W UNIT 841A
UNIVERSAL CITY TX
78148-5456
US

V. Phone/Fax

Practice location:
  • Phone: 210-403-0794
  • Fax: 210-646-0042
Mailing address:
  • Phone: 210-798-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1215354
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: