Healthcare Provider Details

I. General information

NPI: 1679827604
Provider Name (Legal Business Name): FRANCISCO JAVIER ESTRADA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4151 JAIME ZAPATA MEMORIAL HWY STE 103
LAREDO TX
78043-4741
US

IV. Provider business mailing address

9652 MCPHERSON RD SUITE 12
LAREDO TX
78045-6565
US

V. Phone/Fax

Practice location:
  • Phone: 956-615-0047
  • Fax: 956-615-0146
Mailing address:
  • Phone: 956-727-2122
  • Fax: 956-727-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberAP122460
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2012005750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: