Provider Demographics
NPI:1598517633
Name:YEPEZ SISALEMA, GINNA GEOVANNA (MD)
Entity Type:Individual
Prefix:
First Name:GINNA
Middle Name:GEOVANNA
Last Name:YEPEZ SISALEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 KENNEDY HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-4437
Mailing Address - Country:US
Mailing Address - Phone:210-283-6438
Mailing Address - Fax:
Practice Address - Street 1:7615 KENNEDY HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-4437
Practice Address - Country:US
Practice Address - Phone:210-283-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program