Black Diamond Med Spa

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

BLACK DIAMOND MED SPA

Practice address

18730 Stone Oak Pkwy
Ste 106
San Antonio, TX 78258-4140

Phone

(210) 403-2552

Fax

(210) 403-2144

NPI assigned

Jul 31, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Jonas Crafts

Title

Manager

Phone

(210) 403-2552

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1932585965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18730 STONE OAK PKWY",
            "address_2": "STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584140",
            "telephone_number": "210-403-2552",
            "fax_number": "210-403-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18730 STONE OAK PKWY",
            "address_2": "STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584140",
            "telephone_number": "210-403-2552",
            "fax_number": "210-403-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK DIAMOND MED SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "CRAFTS",
        "authorized_official_first_name": "JONAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-403-2552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wasim Bizra, RPH.
• Laurie Bizzell, PH.D.
• Brittany Lee Bizzle, PT
• Jessica Anne Bjerk, ACNP-BC
• BK Med Trans LLC
• Black Dog Home Care, LLC (Right at Home San Antonio)
• Black Nurses Rock San Antonio Chapter
• Black-Pearl Medical LLC
• Christa M Black, PA-C
• Deborah Maye Black

• 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 Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.