Provider Demographics
NPI:1831671114
Name:IZRAL, STEPHANIE (APN, DNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:IZRAL
Suffix:
Gender:F
Credentials:APN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E CEVALLOS APT 125
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-1755
Mailing Address - Country:US
Mailing Address - Phone:630-899-9207
Mailing Address - Fax:
Practice Address - Street 1:2140 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4424
Practice Address - Country:US
Practice Address - Phone:210-736-2262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138508363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health