MEDICARE: JOSEPH P TISCANI DNP, FNP, NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	722575	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60169229	OTHER	TX	DPS #
2	722575	OTHER	TX	LICENSE - NP
3	09697	OTHER	TX	BON PRESCRIPTIVE AUTHORITY
4	1013246834	OTHER	TX	NPI
5	AP118362	OTHER	TX	APRN-CNP

General Provider Information

NPI Number	:	1013246834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH P TISCANI DNP, FNP, NP

Provider Business Mailing Address
First Line	:	18202 CRYSTAL RIDGE DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-3613
Country	:	US
Telephone Number	:	210-393-1061
Fax Number	:

Provider Business Practice Location Address
First Line	:	4118 POND HILL RD STE 300
Second Line	:
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1282
Country	:	US
Telephone Number	:	210-494-3739
Fax Number	:	210-494-4508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	11/13/2024

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