Healthcare Provider Details

I. General information

NPI: 1295214641
Provider Name (Legal Business Name): RACHEL NANCY DAVILA LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/07/2018
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

639 MARIA ELENA
SAN ANTONIO TX
78228-5928
US

V. Phone/Fax

Practice location:
  • Phone: 210-349-7030
  • Fax: 210-349-0097
Mailing address:
  • Phone: 210-383-2401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number146228
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: