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SOVEREIGNTY FUNCTIONAL MEDICINE
NPI 1124983747
Nurse Practitioner - Family in San Antonio, TX

Active since December 16, 2025
3410 STONEY BYU, SAN ANTONIO, TX 78245(210) 416-2075 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Sovereignty Functional Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOVEREIGNTY FUNCTIONAL MEDICINE (NPI 1124983747) is a healthcare organization registered as a family in San Antonio, Texas and active in the NPI registry since December 2025. The organization lists Alma Angelica Lozano Mercado, Provider/manager, as its authorized official.

NPPES Registry Identity

NPI1124983747
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSOVEREIGNTY FUNCTIONAL MEDICINE
Location Address3410 STONEY BYUSan Antonio, TX 78245-4057
Mailing Address2900 E Broadway Blvd Ste 100Tucson, AZ 85716-5344 · (201) 416-2075
Phone(210) 416-2075
Organization SubpartNo
Authorized OfficialAlma Angelica Lozano MercadoProvider/manager · (210) 416-2075
Enumeration DateDecember 16, 2025
NPPES CertifiedDecember 16, 2025
✔ NPI 1124983747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
3410 STONEY BYU, San Antonio, TX 78245
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sovereignty Functional Medicine's NPI number?

The NPI number for Sovereignty Functional Medicine is 1124983747. It was assigned to this organization in the NPPES registry on December 16, 2025.

Where is Sovereignty Functional Medicine located?

Sovereignty Functional Medicine is located at 3410 Stoney Byu, San Antonio, TX 78245. The listed phone number is (210) 416-2075.

What is Sovereignty Functional Medicine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Sovereignty Functional Medicine was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.