Doctor Name: | TIFFANY PINALES |
NPI Number: | 1033547419 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA09279 |
Business Practice Address: | 2790 Pharmacy Rd Ste B Rio Grande City, TX - 785826547 |
Business Phone Number: | 9564877561 |
Business Fax Number: | 9564870097 |
Mailing Address: | 2790 Pharmacy Rd Ste B, RIO GRANDE CITY |
State: | TX |
Postal Code: | 785826547 |
Phone Number: | 9564877561 |
Fax Number: | 9564870097 |
NPI Enumeration Date: | 10/23/2013 |
NPI Last Update Date: | 12/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA09279 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |