Healthcare Provider Details

I. General information

NPI: 1619256989
Provider Name (Legal Business Name): NANCY TURNBULL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY BURGHER

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14800 SAN PEDRO AVE STE 115
SAN ANTONIO TX
78232-3734
US

IV. Provider business mailing address

19141 STONE OAK PKWY STE 104
SAN ANTONIO TX
78258-3367
US

V. Phone/Fax

Practice location:
  • Phone: 866-384-5470
  • Fax:
Mailing address:
  • Phone: 210-756-5989
  • Fax: 210-568-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA07383
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: