Healthcare Provider Details

I. General information

NPI: 1376354589
Provider Name (Legal Business Name): CHRIS INCORVAIA JR. FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 FLOYD CURL DR
SAN ANTONIO TX
78229-3902
US

IV. Provider business mailing address

7700 FLOYD CURL DR
SAN ANTONIO TX
78229-3902
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-4000
  • Fax:
Mailing address:
  • Phone: 419-508-3651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1189131
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number864202
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: