Healthcare Provider Details

I. General information

NPI: 1851265086
Provider Name (Legal Business Name): MY NP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 TESORO DR STE 105
SAN ANTONIO TX
78217-6100
US

IV. Provider business mailing address

2186 JACKSON KELLER RD # 3015
SAN ANTONIO TX
78213-2723
US

V. Phone/Fax

Practice location:
  • Phone: 210-941-6967
  • Fax:
Mailing address:
  • Phone: 210-941-6967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY LONDON
Title or Position: OWNER
Credential: FNP
Phone: 210-941-6967