| Klarisana Physician Services Pllc | |
|
8600 Wurzbach Rd Ste 1110 San Antonio TX 78240 | |
| (210) 556-1430 | |
| Not Available |
| Full Name | Klarisana Physician Services Pllc |
|---|---|
| Speciality | General Practice |
| Location | 8600 Wurzbach Rd Ste 1110, San Antonio, Texas |
| Authorized Official Name and Position | Carl John Bonnett (MANAGING MEMBER) |
| Authorized Official Contact | 3039456054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Klarisana Physician Services Pllc 8600 Wurzbach Rd Ste 1110 San Antonio TX 78240-4334 Ph: (210) 556-1430 | Klarisana Physician Services Pllc 8600 Wurzbach Rd Ste 1110 San Antonio TX 78240 Ph: (210) 556-1430 |
| NPI Number | 1013384866 |
|---|---|
| Provider Enumeration Date | 08/27/2015 |
| Last Update Date | 09/09/2022 |
| Medicare PECOS PAC ID | 1759659238 |
|---|---|
| Medicare Enrollment ID | O20170626001558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013384866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | P8449 (Texas) | Primary |
| Provider Name | Carl J Bonnett |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427007327 PECOS PAC ID: 3577520519 Enrollment ID: I20140623001748 |
| Provider Name | Jennifer Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477916690 PECOS PAC ID: 7315227063 Enrollment ID: I20170717001529 |
| Provider Name | Grace T. Bebeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437693801 PECOS PAC ID: 0143594911 Enrollment ID: I20170918000516 |
| Provider Name | Brea Wenman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639705171 PECOS PAC ID: 9032531702 Enrollment ID: I20200625001546 |
| Provider Name | Chelsea Summer Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851904668 PECOS PAC ID: 6406273630 Enrollment ID: I20200902000512 |
| Provider Name | Sarah Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427512755 PECOS PAC ID: 8729408539 Enrollment ID: I20201016001131 |
| Provider Name | Holly Thrailkill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003361098 PECOS PAC ID: 9931519204 Enrollment ID: I20201028001418 |
| Provider Name | Kyle D. Ransom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821511627 PECOS PAC ID: 7113337536 Enrollment ID: I20201113000153 |
| Provider Name | Jasmine Bonder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740858349 PECOS PAC ID: 8729470919 Enrollment ID: I20220120001344 |
| Provider Name | Sarah K Wycheck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023783362 PECOS PAC ID: 1254708829 Enrollment ID: I20221110002766 |
| Provider Name | Courtney Alexa Szigetvari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598430407 PECOS PAC ID: 7618347667 Enrollment ID: I20230109000337 |
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