MEDICARE: UNIVERSITY OF THE INCARNATE WORD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	1835P1200X	Pharmacotherapy Pharmacist
3	363LF0000X	Family Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033591706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF THE INCARNATE WORD

Provider Business Mailing Address
First Line	:	4301 BROADWAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-6318
Country	:	US
Telephone Number	:	210-283-6331
Fax Number	:	210-829-3174

Provider Business Practice Location Address
First Line	:	2547 E COMMERCE STREET
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78203-1907
Country	:	US
Telephone Number	:	210-283-6331
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	HOLLY ANN DILEO
Credential	:	FNP-BC
Telephone Number	:	210-283-6331

Provider Enumeration Date	:	06/18/2015
Last Update Date	:	10/31/2025

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Directions to “UNIVERSITY OF THE INCARNATE WORD ” Practice Location

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