Healthcare Provider Details

I. General information

NPI: 1366329880
Provider Name (Legal Business Name): BRITTINA SHARIE LEONARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTINA SHARIE BOYNTON

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

IV. Provider business mailing address

9103 SPIGEL WAY
CONVERSE TX
78109-0210
US

V. Phone/Fax

Practice location:
  • Phone: 210-706-7800
  • Fax: 210-443-0333
Mailing address:
  • Phone: 706-573-3849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number307232
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: