Sovereignty Functional Medicine

Family Nurse Practitioner · San Antonio, TX

Call (210) 416-2075 Directions

At a glance

3410 Stoney Byu, San Antonio, TX 78245-4057

NPPES record updated Dec 16, 2025. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

3410 Stoney Byu
San Antonio, TX 78245-4057

Professional details: NPI, taxonomy & registry record

NPI1124983747

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Registry details

Primary taxonomy: Family Nurse Practitioner
Taxonomy code: 363LF0000X
Enumeration date: Dec 16, 2025
Record updated: Dec 16, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Family Nurse Practitioner

363LF0000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

3410 Stoney Byu
San Antonio, TX 78245-4057

Phone: (210) 416-2075

Mailing address

2900 E BROADWAY BLVD STE 100

TUCSON, AZ 857165344

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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