Healthcare Provider Details

I. General information

NPI: 1730730573
Provider Name (Legal Business Name): EDGAR GARATE FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 HOOKS AVE STE B
DONNA TX
78537-3437
US

IV. Provider business mailing address

917 CASA BLANCA
EDINBURG TX
78539-0092
US

V. Phone/Fax

Practice location:
  • Phone: 956-461-2277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP142510
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: