Healthcare Provider Details

I. General information

NPI: 1750186318
Provider Name (Legal Business Name): VANESSA CABRALES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CAMINO LA COSTA
AUSTIN TX
78752-3930
US

IV. Provider business mailing address

1101 CAMINO LA COSTA
AUSTIN TX
78752-3930
US

V. Phone/Fax

Practice location:
  • Phone: 512-478-4939
  • Fax: 512-708-1835
Mailing address:
  • Phone: 512-478-4939
  • Fax: 512-708-1835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1107503
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: