Provider Demographics
NPI:1932774064
Name:SAN MIGUEL, SAMANTHA PRICE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:PRICE
Last Name:SAN MIGUEL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 DASHWOOD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2288
Mailing Address - Country:US
Mailing Address - Phone:210-367-7904
Mailing Address - Fax:
Practice Address - Street 1:10007 HUEBNER RD BLDG SUITE402
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1640
Practice Address - Country:US
Practice Address - Phone:210-692-0361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1028200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily