Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1055529 | TX |
NPI | 1013661610 |
---|---|
Provider Name | Alba Esther Cereceres |
First Address | Seguin, TX 78155-6753 |
Second Address | San Antonio, TX 78240-5251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2022 |
Last Update Date | 11/02/2022 |