Healthcare Provider Details

I. General information

NPI: 1982968970
Provider Name (Legal Business Name): CHRISTINA M. MKHANTAR NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA M MKHANTAR NP-C

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4242 MEDICAL DR SUITE 6250
SAN ANTONIO TX
78229
US

IV. Provider business mailing address

4242 MEDICAL DR SUITE 6250
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-479-3297
  • Fax: 210-479-3295
Mailing address:
  • Phone: 210-479-3297
  • Fax: 210-479-3295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0512394
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: