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General NPI Number Information
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NPI Number | 1083436604
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Entity Type | Individual
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Provider Name | SAMANTHA LEE ANN BRUNINK FNP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 9234 N LOOP 1604 W STE 110
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City | SAN ANTONIO
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State | TX
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Zip | 78249-2981
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Country | US
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Telephone | 512-987-8435
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Fax | 833-864-3533
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Provider Business Mailing Address
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Address Line | 9234 N LOOP 1604 W STE 110
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City | SAN ANTONIO
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State | TX
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Zip | 78249-2981
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Country | US
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Telephone | 512-987-8435
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Fax | 833-864-3533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1179656
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95032641
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License Number State | CA
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