Healthcare Provider Details

I. General information

NPI: 1619401601
Provider Name (Legal Business Name): JESSIKA D. WEBER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S ZARZAMORA ST
SAN ANTONIO TX
78207-5209
US

IV. Provider business mailing address

701 S ZARZAMORA ST
SAN ANTONIO TX
78207-5209
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-7551
  • Fax:
Mailing address:
  • Phone: 210-358-7551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW1016
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberW1016
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: