Healthcare Provider Details

I. General information

NPI: 1598326597
Provider Name (Legal Business Name): JONATHAN WESLEY LINDER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 ENRIQUE M BARRERA PKWY
SAN ANTONIO TX
78227-2210
US

IV. Provider business mailing address

277 BUDDY GANEM DR STE A
PORTLAND TX
78374-3202
US

V. Phone/Fax

Practice location:
  • Phone: 210-538-8386
  • Fax:
Mailing address:
  • Phone: 361-777-3900
  • Fax: 361-413-0274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141894
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: