Healthcare Provider Details

I. General information

NPI: 1831120344
Provider Name (Legal Business Name): JESSICA LENORE PIERCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LENORE FALER

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4458 MEDICAL DR STE 205
SAN ANTONIO TX
78229-3748
US

IV. Provider business mailing address

16620 N US HIGHWAY 281 STE 300
SAN ANTONIO TX
78232-2679
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-1515
  • Fax: 210-615-6904
Mailing address:
  • Phone: 210-614-1231
  • Fax: 210-499-0811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberM2751
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: