Healthcare Provider Details

I. General information

NPI: 1184103103
Provider Name (Legal Business Name): AMBER LYNN ATON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5726 W HAUSMAN RD STE 100
SAN ANTONIO TX
78249-1651
US

IV. Provider business mailing address

12103 EDWARD CONRAD
SAN ANTONIO TX
78253-5093
US

V. Phone/Fax

Practice location:
  • Phone: 210-349-7030
  • Fax:
Mailing address:
  • Phone: 210-508-7435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number950947
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: