Provider Demographics
NPI:1699173435
Name:PENTECOST, ANGELICA M (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:M
Last Name:PENTECOST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-334-3715
Mailing Address - Fax:210-924-1374
Practice Address - Street 1:207 E. EVERGREEN ST.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-0000
Practice Address - Country:US
Practice Address - Phone:210-223-3543
Practice Address - Fax:210-924-1374
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP126307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily