=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033177837
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTA M BLACK PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2006
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8300 FLOYD CURL DR FL 4
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-3931
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-450-9200
-----------------------------------------------------
Fax | 210-450-6013
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 335 E SONTERRA BLVD STE 200
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-4385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-615-8500
-----------------------------------------------------
Fax | 210-615-8501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0110004943
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA05376
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------