Healthcare Provider Details

I. General information

NPI: 1316523244
Provider Name (Legal Business Name): SEAN MCCARTHY FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 AUSTIN HWY STE 214
SAN ANTONIO TX
78209-4867
US

IV. Provider business mailing address

2961 MOSSROCK
SAN ANTONIO TX
78230-5119
US

V. Phone/Fax

Practice location:
  • Phone: 210-828-2531
  • Fax: 210-828-2532
Mailing address:
  • Phone: 210-731-4800
  • Fax: 210-731-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1030513
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: