Provider Demographics
NPI:1013541788
Name:CONSTANTE, DIONISIA
Entity Type:Individual
Prefix:
First Name:DIONISIA
Middle Name:
Last Name:CONSTANTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6818 CALLE BRISENO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-1908
Mailing Address - Country:US
Mailing Address - Phone:210-981-8081
Mailing Address - Fax:
Practice Address - Street 1:7510 TALLEY RD LOT 12
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4726
Practice Address - Country:US
Practice Address - Phone:210-981-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12241981Medicaid