Healthcare Provider Details

I. General information

NPI: 1154842474
Provider Name (Legal Business Name): ALLISON WAGNER ESPINOSA AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16723 HUEBNER RD
SAN ANTONIO TX
78248-2351
US

IV. Provider business mailing address

903 W MARTIN ST # MS 49-2
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-644-3600
  • Fax: 210-702-6963
Mailing address:
  • Phone: 210-358-5909
  • Fax: 210-358-5940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number51115
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: