Provider Demographics
NPI:1083150874
Name:MILTENBERG, DANIELLE (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MILTENBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 W SUNSET RD STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1771
Mailing Address - Country:US
Mailing Address - Phone:210-564-8300
Mailing Address - Fax:210-564-8399
Practice Address - Street 1:414 W SUNSET RD STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1771
Practice Address - Country:US
Practice Address - Phone:210-564-8300
Practice Address - Fax:210-564-8399
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117570363A00000X
TXPA19010363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant