Provider Demographics
NPI:1306811211
Name:SANMARTIN, OLIVIA E (FNP)
Entity type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:E
Last Name:SANMARTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:OLIVIA
Other - Middle Name:E
Other - Last Name:ZEPEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:6243 IH 10 WEST
Mailing Address - Street 2:STE 480
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-2089
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:6428 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1511
Practice Address - Country:US
Practice Address - Phone:210-520-4455
Practice Address - Fax:210-520-4421
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221082363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F3371OtherMEDICARE #