Organization · Type 2 NPI
Sovereignty Functional Medicine
Family Nurse Practitioner · San Antonio, TX
NPI number
1124983747
Active
Practice location
3410 Stoney Byu
San Antonio, TX 78245-4057
Mailing address
2900 E Broadway Blvd Ste 100
Tucson, AZ 85716-5344
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
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About NPI 1124983747
Sovereignty Functional Medicine's National Provider Identifier is 1124983747, issued on Dec 16, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Antonio, TX. The record was last updated on Dec 16, 2025.