Healthcare Provider Details
I. General information
NPI: 1336798289
Provider Name (Legal Business Name): HARTMAN ADVANCED PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1814 ELMWOOD AVENUE TELEMEDICINE OFFICE
HARLINGEN TX
78550-8000
US
IV. Provider business mailing address
1814 ELMWOOD AVENUE TELEMEDICINE OFFICE
HARLINGEN TX
78550-8000
US
V. Phone/Fax
- Phone: 956-245-8371
- Fax: 956-231-0798
- Phone: 956-245-8371
- Fax: 956-231-0798
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
LYNNE
HARTMAN
Title or Position: CEO/OWNER
Credential: APRN, FNP-BC
Phone: 956-245-8371