Healthcare Provider Details

I. General information

NPI: 1194759126
Provider Name (Legal Business Name): BRIANNE NEWMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BREE NEWMAN

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 W LOOP 1604 N
SAN ANTONIO TX
78251-3350
US

IV. Provider business mailing address

602 E NOTTINGHAM DR
SAN ANTONIO TX
78209-3438
US

V. Phone/Fax

Practice location:
  • Phone: 210-888-0008
  • Fax:
Mailing address:
  • Phone: 804-517-6784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA12591
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0009542
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number216277
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: