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General NPI Number Information
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NPI Number | 1811805443
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Entity Type | Organization
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Legal Business Name | WYNTEQUEON
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 19141 STONE OAK PARK WAY SUITE #104
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 469-842-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 19141 STONE OAK PARK WAY SUITE #104
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 469-842-4988
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | DR. WINSOME ASHLEY
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Credential | PH.D.
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Telephone | 469-842-4988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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