Healthcare Provider Details

I. General information

NPI: 1184904336
Provider Name (Legal Business Name): JENNIFER L ZAVALA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19272 STONE OAK PKWY SUITE 101
SAN ANTONIO TX
78258-3371
US

IV. Provider business mailing address

19272 STONE OAK PKWY STE 101
SAN ANTONIO TX
78258-3372
US

V. Phone/Fax

Practice location:
  • Phone: 210-265-8851
  • Fax: 210-265-8855
Mailing address:
  • Phone: 210-265-8851
  • Fax: 210-265-8855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAP120771
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP120771
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: