Provider Demographics
NPI:1780683888
Name:BRUNE, SONJA D (CNS)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:D
Last Name:BRUNE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 VILLAGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5415
Mailing Address - Country:US
Mailing Address - Phone:210-297-2150
Mailing Address - Fax:210-297-2159
Practice Address - Street 1:8811 VILLAGE DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5415
Practice Address - Country:US
Practice Address - Phone:210-297-2150
Practice Address - Fax:210-297-2159
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX553923364S00000X
TXAP110040364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044356605Medicaid
TX044356601Medicaid
TX88N001OtherBCBS
TX88N001OtherBCBS
TX8L11052Medicare PIN