Healthcare Provider Details

I. General information

NPI: 1447988795
Provider Name (Legal Business Name): CLAUDIA EDITH BEJARANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/27/2022
Certification Date: 08/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 PAREDES LINE RD
BROWNSVILLE TX
78521-1609
US

IV. Provider business mailing address

2155 PAREDES LINE RD
BROWNSVILLE TX
78521-1609
US

V. Phone/Fax

Practice location:
  • Phone: 956-574-9707
  • Fax:
Mailing address:
  • Phone: 956-574-9707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number303218
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: