MEDICARE: MRS. OLIVIA E. SANMARTIN F.N.P.

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	363L00000X	Nurse Practitioner	221082	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F3371	OTHER	TX	MEDICARE #

General Provider Information

NPI Number	:	1306811211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. OLIVIA E. SANMARTIN F.N.P.

Provider Business Mailing Address
First Line	:	6243 IH 10 WEST
Second Line	:	STE 480
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-2089
Country	:	US
Telephone Number	:	210-731-4800
Fax Number	:	210-731-4810

Provider Business Practice Location Address
First Line	:	6428 BANDERA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1511
Country	:	US
Telephone Number	:	210-520-4455
Fax Number	:	210-520-4421

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	06/04/2010

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Directions to “ MRS. OLIVIA E. SANMARTIN F.N.P.” Practice Location

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