Provider Demographics
NPI:1376259440
Name:QUINTANILLA, ERIC (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:QUINTANILLA
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 GRAY FOX CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3287
Mailing Address - Country:US
Mailing Address - Phone:940-224-4634
Mailing Address - Fax:
Practice Address - Street 1:5000 BAPTIST HEALTH DR STE 117
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1194
Practice Address - Country:US
Practice Address - Phone:210-598-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1084602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily