Healthcare Provider Details

I. General information

NPI: 1306314075
Provider Name (Legal Business Name): JUNE MARIE GBAPAYWEA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2018
Last Update Date: 11/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 CROWNHILL BLVD STE 300
SAN ANTONIO TX
78209-1128
US

IV. Provider business mailing address

7820 WOODCHASE APT 714
SAN ANTONIO TX
78240-2953
US

V. Phone/Fax

Practice location:
  • Phone: 210-824-5530
  • Fax: 210-824-5323
Mailing address:
  • Phone: 309-530-7616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number942881
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: