Healthcare Provider Details

I. General information

NPI: 1881283059
Provider Name (Legal Business Name): STEVE CLAIR SCOTT PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 11/27/2024
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14327 BLANCO RD
SAN ANTONIO TX
78216-7723
US

IV. Provider business mailing address

3803 AMBER CHASE
SAN ANTONIO TX
78245-2949
US

V. Phone/Fax

Practice location:
  • Phone: 210-245-7933
  • Fax:
Mailing address:
  • Phone: 512-497-1844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1017842
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1017842
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: