Healthcare Provider Details

I. General information

NPI: 1801689708
Provider Name (Legal Business Name): AMANDA JANE TRUJILLO-RUEDAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 W IH 10 STE 201
SAN ANTONIO TX
78230-3879
US

IV. Provider business mailing address

8000 W IH 10 STE 201
SAN ANTONIO TX
78230-3879
US

V. Phone/Fax

Practice location:
  • Phone: 210-944-4133
  • Fax:
Mailing address:
  • Phone: 210-944-4133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number939625
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1203974
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: