Provider Demographics
NPI:1841887502
Name:TRUJILLO, ROBERTO JAIME (AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:JAIME
Last Name:TRUJILLO
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11130 CHRISTUS HLS STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3586
Mailing Address - Country:US
Mailing Address - Phone:210-228-0044
Mailing Address - Fax:210-228-0045
Practice Address - Street 1:11130 CHRISTUS HLS STE 207
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3586
Practice Address - Country:US
Practice Address - Phone:210-228-0044
Practice Address - Fax:210-228-0045
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1020434363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty