Healthcare Provider Details

I. General information

NPI: 1467290874
Provider Name (Legal Business Name): JANETTE PICCIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 VETERANS DR
HARLINGEN TX
78550-8942
US

IV. Provider business mailing address

4412 TAHOE LAKE DR
BROWNSVILLE TX
78520-4076
US

V. Phone/Fax

Practice location:
  • Phone: 956-382-2075
  • Fax:
Mailing address:
  • Phone: 956-517-9846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number639670
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: