ENCINO PARK FAMILY HEALTH & WELLNESS CLINIC (NPI# 1457902256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457902256 |
| Entity Type | Organization |
| Organization Name | ENCINO PARK FAMILY HEALTH & WELLNESS CLINIC |
| Practice Address |
13423 Blanco Rd # 8046 San Antonio TX 78216-2187 |
| Mailing Address |
Po Box 53666 Midland TX 79710-3666 |
| Practice Telephone | 2105685816 |
| Practice Fax Number | 2103994637 |
| Mailing Telephone | 2105685816 |
| Mailing Fax Number | 2103994637 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | JOHN LEAL (OWNER) |
| Authorized Official Telephone | 2105685816 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
13423 BLANCO RD # 8046 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78216-2187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356762405 | John Leal | Nurse Practitioner | 13423 Blanco Rd # 8046, San Antonio, TX 78216-2187 | 2013-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376179820 | Damiana Lea Mcmahan | Speech-Language Pathologist | 12 Inter Park Blvd, #105, San Antonio, TX 78216 | 2020-03-17 |
| 1811530967 | Hacienda Hospice, Ltd | Hospice Care, Community Based | 101 W Silver Sands Dr, San Antonio, TX 78216 | 2019-10-22 |
| 1437792876 | Eddy Sidra | Optometrist | 7400 San Pedro Avenue, Suite 486, San Antonio, TX 78216 | 2019-10-17 |
| 1083256796 | Tiffany Michelle Goericke | Physical Therapist | 502 East Ramsey, San Antonio, TX 78216 | 2019-10-14 |
| 1780246942 | Esperanza Eating Disorders Center, Pllc | Clinic/Center | 403 E. Ramsey, Suite 204, San Antonio, TX 78216 | 2019-07-08 |
| 1568938314 | Lyric Lea Lewis | Licensed Vocational Nurse | 85 Ne Interstate 410 Loop #500, San Antonio, TX 78216 | 2018-10-19 |
| 1912488206 | Rebecca Anna Poppe | Licensed Vocational Nurse | 1514 Vista Del Norte, San Antonio, TX 78216 | 2018-08-24 |
| 1205338779 | Bailee Hannah Mokry | Behavioral Analyst | 11306 Sir Winston, San Antonio, TX 78216 | 2018-03-01 |
| 1487155677 | Ojer Corbie | Behavior Technician | 11310 Sir Winston At Bld D, San Antonio, TX 78216 | 2018-02-23 |
| 1366943631 | Briana Nicole Rodriguez | Behavior Technician | 14235 Blanco Road, San Antonio, TX 78216 | 2018-02-22 |
| Find all providers in zip 78216 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573443 | Elizabeth Danielle Benavides | Clinic/Center | 1424 Tanager Ct, San Antonio, TX 78260-2455 | 2020-09-16 |
| 1962041558 | Synergenx Health - Alamo Ranch San Antonio LLC | Clinic/Center | Culebra Commons, Phase II, W Loop 1604 N and Culebra Rd, Suite 204, San Antonio, TX 78254 | 2019-12-30 |
| 1013488626 | Campus Bullis Primary Care | Clinic/Center | 6865 Camp Bullis, Suite 201, San Antonio, TX 78256 | 2018-12-07 |
| 1730665779 | Nutrition for You LLC | Clinic/Center | 1103 Red Rock Rnch, San Antonio, TX 78245-4435 | 2018-07-12 |
| 1285133983 | Medical Care Innovation, P.C. | Clinic/Center | 110000 Rogers Run, San Antonio, TX 78251 | 2018-02-08 |
| 1962936468 | Synergenx Health - Northwest San Antonio LLC | Clinic/Center | 11163 W Loop 1604 N Ste 203, San Antonio, TX 78254-2266 | 2017-04-12 |
| 1124578018 | Alison Wiesenthal, Md, Pa | Clinic/Center | 333 W Olmos Dr, San Antonio, TX 78212-1959 | 2016-10-04 |
| 1679925242 | Tenet | Clinic/Center | 8200 Perrin Beitel Rd, San Antonio, TX 78218-1547 | 2016-07-07 |
| 1841664067 | Centro Medico Familiar Ebenezer | Clinic/Center | 5650 N Foster Rd, San Antonio, TX 78244-1106 | 2015-11-27 |
| 1700205747 | Primary Wellness Associates, LLC | Clinic/Center | 131 E Terra Alta Dr, San Antonio, TX 78209-2742 | 2014-04-07 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78216 |
Please comment or provide details below to improve the information on ENCINO PARK FAMILY HEALTH & WELLNESS CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.