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NPI Code Detail

MEDICARE: MRS. JEANINE BOSTIC WATKINS LVN

MEDICARE: MRS. JEANINE BOSTIC WATKINS LVN
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
1164X00000XLicensed Vocational Nurse215239TX

General Provider Information

NPI Number : 1518752872
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEANINE BOSTIC WATKINS LVN
Provider Business Mailing Address
First Line : 7626 MAYCREST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78250-6040
Country : US
Telephone Number : 210-969-7400
Fax Number : 210-590-1054
Provider Business Practice Location Address
First Line : 6938 WALZEM RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78239-3641
Country : US
Telephone Number : 210-969-7400
Fax Number : 210-590-1054
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2025
Last Update Date : 04/09/2025

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