Healthcare Provider Details

I. General information

NPI: 1902235948
Provider Name (Legal Business Name): JEANETTE ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 MEDICAL DR SUITE 100
SAN ANTONIO TX
78229-3822
US

IV. Provider business mailing address

PO BOX 911230
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 210-595-5300
  • Fax: 210-595-5301
Mailing address:
  • Phone: 972-997-8000
  • Fax: 972-234-0813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number570018
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: