Doctor Name: | MARIETTA MENESES BERMUDEZ |
NPI Number: | 1033512868 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | AP126286 |
Business Practice Address: | 400 W. Business 77 San Benito, TX - 78586 |
Business Phone Number: | 9563991641 |
Business Fax Number: | |
Mailing Address: | 1801 S Reynolds, RIO HONDO |
State: | TX |
Postal Code: | 785833154 |
Phone Number: | 9565366664 |
Fax Number: | |
NPI Enumeration Date: | 10/07/2014 |
NPI Last Update Date: | 03/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP126286 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |