Healthcare Provider Details

I. General information

NPI: 1043636533
Provider Name (Legal Business Name): JUDEMAE CABRERA ESCOVILLA APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2014
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 N COL ROWE BLVD STE A
MCALLEN TX
78501-2304
US

IV. Provider business mailing address

PO BOX 4767
MCALLEN TX
78502-4767
US

V. Phone/Fax

Practice location:
  • Phone: 956-362-5030
  • Fax: 956-362-5035
Mailing address:
  • Phone: 956-362-5030
  • Fax: 956-362-5035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP125435
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: