Healthcare Provider Details

I. General information

NPI: 1033561279
Provider Name (Legal Business Name): JULIE TABINGO CRNA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E RIDGE RD STE 3
MCALLEN TX
78503-1536
US

IV. Provider business mailing address

4228 N MCCOLL RD
MCALLEN TX
78504-2523
US

V. Phone/Fax

Practice location:
  • Phone: 956-682-4151
  • Fax: 956-682-4154
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JULIE MEZA
Title or Position: DIRECT OWNER/PROVIDER
Credential: CRNA
Phone: 956-682-4151