Healthcare Provider Details

I. General information

NPI: 1285250159
Provider Name (Legal Business Name): ELIZABETH OLMOS-CASTANEDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH MEECE RN

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N FRIO ST BLDG 1
SAN ANTONIO TX
78207-3011
US

IV. Provider business mailing address

6800 PARK TEN BLVD STE 200S
SAN ANTONIO TX
78213-4293
US

V. Phone/Fax

Practice location:
  • Phone: 210-261-1060
  • Fax:
Mailing address:
  • Phone: 210-261-1060
  • Fax: 210-261-1821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP145990
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: