Provider Demographics
NPI:1316376742
Name:VLASAK, DONNA (RN, FNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:VLASAK
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 SW MILITARY DR
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1579
Mailing Address - Country:US
Mailing Address - Phone:210-927-6600
Mailing Address - Fax:210-927-6603
Practice Address - Street 1:919 SW MILITARY DR
Practice Address - Street 2:STE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1579
Practice Address - Country:US
Practice Address - Phone:210-927-6600
Practice Address - Fax:210-927-6603
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX508692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily