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General NPI Number Information
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NPI Number | 1699614909
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Entity Type | Organization
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Legal Business Name | ISJ HEALTHCARE
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 9810 TEXAS-151
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City | SAN ANTONIO
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State | TX
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Zip | 78251
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Country | US
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Telephone | 956-707-4005
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Fax |
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Provider Business Mailing Address
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Address Line | 20711 WILDERNESS OAK STE 107
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City | SAN ANTONIO
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State | TX
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Zip | 78258-2641
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Country | US
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Telephone | 956-707-4005
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MRS. ILIANA JACKSON
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Credential | FNP
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Telephone | 956-707-4005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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