Provider Demographics
NPI:1851644868
Name:HOOVER, JOHN DAVID SR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:HOOVER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:DAVID
Other - Last Name:HOOVER
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:15900 LA CANTERA PKWY STE 20265
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2471
Mailing Address - Country:US
Mailing Address - Phone:210-314-4740
Mailing Address - Fax:
Practice Address - Street 1:15900 LA CANTERA PKWY STE 20265
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2471
Practice Address - Country:US
Practice Address - Phone:210-314-4740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX723639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily