Healthcare Provider Details

I. General information

NPI: 1659704625
Provider Name (Legal Business Name): MAYRA JANNETTE PLIEGO RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 03/07/2023
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 MCPHERSON RD STE 300
LAREDO TX
78045-6880
US

IV. Provider business mailing address

2438 MONARCH DR STE A-125
LAREDO TX
78045-6600
US

V. Phone/Fax

Practice location:
  • Phone: 956-795-1160
  • Fax:
Mailing address:
  • Phone: 956-523-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP123704
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: