MEDICARE: BOBBIE ROMERO NGUYEN APRN

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	AP138765	TX
2	363L00000X	Nurse Practitioner	AP138765	TX

General Provider Information

NPI Number	:	1427531920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBIE ROMERO NGUYEN APRN

Provider Business Mailing Address
First Line	:	4411 MEDICAL DR STE 300
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3824
Country	:	US
Telephone Number	:	210-614-5400
Fax Number	:	210-614-4244

Provider Business Practice Location Address
First Line	:	21727 IH 10 W STE 103
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-644-1200
Fax Number	:

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	05/20/2024

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