Healthcare Provider Details

I. General information

NPI: 1912564121
Provider Name (Legal Business Name): EMILY CAROL CAIN WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY CAROL CARDER WHNP-BC

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 S GENERAL MCMULLEN DR
SAN ANTONIO TX
78226-1190
US

IV. Provider business mailing address

903 W MARTIN ST # MS 49-2
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-8255
  • Fax: 210-644-8507
Mailing address:
  • Phone: 210-358-5909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP137571
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: