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General NPI Number Information
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NPI Number | 1326428798
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Entity Type | Individual
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Provider Name | JENNIFER NELSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 10407 STATE HIGHWAY 151
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4551
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Country | US
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Telephone | 210-877-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 9035 WELLESLEY MANOR DR
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City | SAN ANTONIO
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State | TX
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Zip | 78240-2165
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Country | US
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Telephone | 701-720-2718
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | S9945
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License Number State | TX
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