Healthcare Provider Details

I. General information

NPI: 1396227856
Provider Name (Legal Business Name): MAXINE LERMA ARANDA MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2018
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 JACKSON KELLER RD
SAN ANTONIO TX
78213-2722
US

IV. Provider business mailing address

799 MARSHALL LN
POTEET TX
78065-4617
US

V. Phone/Fax

Practice location:
  • Phone: 210-501-0703
  • Fax:
Mailing address:
  • Phone: 210-287-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAP138392
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: