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NPI Code Detail

MEDICARE: FERNANDO AVILA

MEDICARE: FERNANDO AVILA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician140107343523138TX

General Provider Information

NPI Number : 1518408814
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDO AVILA
Provider Business Mailing Address
First Line : 5702 WEBER RD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3965
Country : US
Telephone Number : 361-834-6360
Fax Number :
Provider Business Practice Location Address
First Line : 5702 WEBER RD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3965
Country : US
Telephone Number : 361-834-6360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2017
Last Update Date : 03/20/2017

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Directions to “ FERNANDO AVILA ” Practice Location

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