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General NPI Number Information
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NPI Number | 1093392987
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Entity Type | Individual
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Provider Name | MAYERY BARROSO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 6428 BANDERA RD
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City | SAN ANTONIO
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State | TX
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Zip | 78238-1511
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Country | US
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Telephone | 210-520-4455
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Fax | 210-520-4421
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Provider Business Mailing Address
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Address Line | 2961 MOSSROCK
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City | SAN ANTONIO
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State | TX
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Zip | 78230-5119
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Country | US
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Telephone | 210-731-4800
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Fax | 210-731-4810
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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 | 1024054
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License Number State | TX
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