Healthcare Provider Details

I. General information

NPI: 1972734556
Provider Name (Legal Business Name): FERNANDO CABRERA RN, MSN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 SUNRISE LN
PALMHURST TX
78573-8370
US

IV. Provider business mailing address

1707 SUNRISE LN
PALMHURST TX
78573-8370
US

V. Phone/Fax

Practice location:
  • Phone: 956-867-2221
  • Fax:
Mailing address:
  • Phone: 956-867-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number600580
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: