Healthcare Provider Details

I. General information

NPI: 1407687932
Provider Name (Legal Business Name): ALEXIS KOREN SEKULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18707 HARDY OAK BLVD STE 475
SAN ANTONIO TX
78258-4791
US

IV. Provider business mailing address

10740 N GESSNER RD STE 310
HOUSTON TX
77064-1240
US

V. Phone/Fax

Practice location:
  • Phone: 210-499-4589
  • Fax:
Mailing address:
  • Phone: 281-897-0416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1051059
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1051059
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: