Healthcare Provider Details

I. General information

NPI: 1285487744
Provider Name (Legal Business Name): PRISCILLA HOVER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3152 NAPIER PARK
SHAVANO PARK TX
78231-1536
US

IV. Provider business mailing address

3338 STONEY KNL
SAN ANTONIO TX
78245-4061
US

V. Phone/Fax

Practice location:
  • Phone: 210-492-1666
  • Fax:
Mailing address:
  • Phone: 224-374-8430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA17763
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: