Provider Demographics
NPI:1487133401
Name:IHESIABA, FRANCIS O (RN)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:O
Last Name:IHESIABA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11342 EAGLE TREE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-9573
Mailing Address - Country:US
Mailing Address - Phone:210-388-4582
Mailing Address - Fax:
Practice Address - Street 1:11342 EAGLE TREE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-9573
Practice Address - Country:US
Practice Address - Phone:210-388-4582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX884654163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse