Healthcare Provider Details

I. General information

NPI: 1154985646
Provider Name (Legal Business Name): SHERRY WEBBER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 BROADWAY ST STE 100
SAN ANTONIO TX
78215-1148
US

IV. Provider business mailing address

418 N LOOP 1604 W
SAN ANTONIO TX
78232-1456
US

V. Phone/Fax

Practice location:
  • Phone: 210-595-1019
  • Fax: 210-251-3194
Mailing address:
  • Phone: 210-595-1019
  • Fax: 210-251-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP140884
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: