Sophie Belle Deahl De Sequera, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1090460 Issued in TX

Practice address

9647 Huebner Rd
San Antonio, TX 78240-1512

Phone

(210) 735-5225

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1124749254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25147 FLYING ARROW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782582721",
            "telephone_number": "210-884-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9647 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401512",
            "telephone_number": "210-735-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SEQUERA",
        "first_name": "SOPHIE",
        "middle_name": "BELLE DEAHL",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "942614",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1090460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cesar Eduardo De Paz, M.D.
• Nathaly De Robles Serrano, PA
• Amanda De Santiago
• Dora De Santiago
• Adam Gabriel De Sequera
• Anil Mohan De Silva, M.D.
• Palla Rivi De Silva, M.D.
• Pieter De Smidt, P.T.
• Sylvia Cho De Sola, MD
• Sandra Ann De Sousa

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.