Healthcare Provider Details

I. General information

NPI: 1487243796
Provider Name (Legal Business Name): ESGUERRA AND REBUGIO ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E NOLANA LOOP STE B
PHARR TX
78577-9684
US

IV. Provider business mailing address

300 E NOLANA LOOP STE B
PHARR TX
78577-9684
US

V. Phone/Fax

Practice location:
  • Phone: 956-715-8292
  • Fax:
Mailing address:
  • Phone: 956-715-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RIZALINA LAGAS
Title or Position: FNP-C/ADMINISTRATOR
Credential: APRN-CNP
Phone: 956-588-9198