1952852543 NPI number — ERICA S GLASPER FNP, MSN

Table of content: ERICA S GLASPER FNP, MSN (NPI 1952852543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952852543 NPI number — ERICA S GLASPER FNP, MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GLASPER
Provider First Name:
ERICA
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP, MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952852543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 NE LOOP 410 STE 850
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78216-5824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-805-9800
Provider Business Mailing Address Fax Number:
210-805-8770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3202 CHERRY RIDGE DR STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78230-4830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-441-4333
Provider Business Practice Location Address Fax Number:
210-441-4330
Provider Enumeration Date:
10/18/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  827775 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP132309 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3642886-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".