Healthcare Provider Details

I. General information

NPI: 1659811057
Provider Name (Legal Business Name): CHARLA MIXON APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLA MIXON LAPOINT APRN-CNP

II. Dates (important events)

Enumeration Date: 03/03/2017
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 N VETERANS BLVD
EAGLE PASS TX
78852-3302
US

IV. Provider business mailing address

PO BOX 1470
EAGLE PASS TX
78853-1470
US

V. Phone/Fax

Practice location:
  • Phone: 830-773-5358
  • Fax: 830-773-0258
Mailing address:
  • Phone: 830-773-8917
  • Fax: 830-773-1892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9166076
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-1205686
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: