Provider Demographics
NPI:1720408727
Name:SOMMERHALDER, ASHLEY ALYSSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ALYSSE
Last Name:SOMMERHALDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19707 W INTERSTATE 10 STE 213
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1748
Mailing Address - Country:US
Mailing Address - Phone:210-946-3100
Mailing Address - Fax:210-946-3100
Practice Address - Street 1:19707 W INTERSTATE 10 STE 213
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1748
Practice Address - Country:US
Practice Address - Phone:210-946-3100
Practice Address - Fax:210-946-3100
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8920207Q00000X
LAMD.305577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine