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General NPI Number Information
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NPI Number | 1043114127
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Entity Type | Organization
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Legal Business Name | MOSAIC WOMEN'S WELLNESS, PLLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 8700 CROWNHILL BLVD STE 206
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1126
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Country | US
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Telephone | 210-355-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 8700 CROWNHILL BLVD STE 206
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | BRENDA WALLACE
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Credential | FNP
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Telephone | 210-355-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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