Healthcare Provider Details

I. General information

NPI: 1437636990
Provider Name (Legal Business Name): DAISY TERAN LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 W TEEGE AVE
HARLINGEN TX
78550-4667
US

IV. Provider business mailing address

6332 N FM 1015
MERCEDES TX
78570-5676
US

V. Phone/Fax

Practice location:
  • Phone: 956-412-3337
  • Fax:
Mailing address:
  • Phone: 956-375-7902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number233550
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: