Provider Demographics
NPI:1316489511
Name:TUAZON, DAVIN (AGCNS-BC)
Entity type:Individual
Prefix:
First Name:DAVIN
Middle Name:
Last Name:TUAZON
Suffix:
Gender:M
Credentials:AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 SAN PEDRO AVE # 316
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6219
Mailing Address - Country:US
Mailing Address - Phone:210-745-0084
Mailing Address - Fax:210-745-0139
Practice Address - Street 1:15102 JONES MALTSBERGER RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3367
Practice Address - Country:US
Practice Address - Phone:210-745-0084
Practice Address - Fax:210-745-0139
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-06
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131344364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist