Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Gerontology
Enumerated
Mar 18, 2021
License(s)
1051292 (TX), 2000254647 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1451 ALLISON DR | New Braunfels, TX 78130-7710 | 830-214-3701 |
| MAILING | 1451 ALLISON DR | New Braunfels, TX 78130-7710 | 830-214-3701 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.