Provider Demographics
NPI:1952988800
Name:MINIHAN, BROOKE BOUNDS (FNP-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:BOUNDS
Last Name:MINIHAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 BABCOCK RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6009
Mailing Address - Country:US
Mailing Address - Phone:210-951-9055
Mailing Address - Fax:
Practice Address - Street 1:2829 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6028
Practice Address - Country:US
Practice Address - Phone:210-951-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1095939363LF0000X
TX718760163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse