Healthcare Provider Details

I. General information

NPI: 1881970937
Provider Name (Legal Business Name): MARLENE PALIT APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2011
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 NW LOOP 410 STE 100A
SAN ANTONIO TX
78213-2220
US

IV. Provider business mailing address

3407 COPPER BREAKS
SAN ANTONIO TX
78247-3049
US

V. Phone/Fax

Practice location:
  • Phone: 210-886-8031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number456331
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: