Healthcare Provider Details

I. General information

NPI: 1073924353
Provider Name (Legal Business Name): HENRY DESTURA YEE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 LINDBERG AVE
MCALLEN TX
78501-2913
US

IV. Provider business mailing address

721 LINDBERG AVE
MCALLEN TX
78501-2913
US

V. Phone/Fax

Practice location:
  • Phone: 956-668-7746
  • Fax: 956-668-8338
Mailing address:
  • Phone: 956-668-7746
  • Fax: 956-668-8338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP125523
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: