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General NPI Number Information
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NPI Number | 1295691160
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Entity Type | Organization
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Legal Business Name | ELITE REJUVENATION CLINIC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 9258 CULEBRA RD
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City | SAN ANTONIO
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State | TX
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Zip | 78251-2871
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Country | US
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Telephone | 210-425-9055
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 CLOVER CT
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City | ADKINS
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State | TX
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Zip | 78101-2601
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Country | US
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Telephone | 210-425-9055
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER - OWNER
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Name | MS. ELAINE LORETTA ZAMORA
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Credential | FNP-C
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Telephone | 210-425-9055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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