Healthcare Provider Details

I. General information

NPI: 1780242461
Provider Name (Legal Business Name): FRANCISCO DANIEL LUGO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 S BRIDGE AVE
WESLACO TX
78596-7129
US

IV. Provider business mailing address

2955 DANA ST
BROWNSVILLE TX
78521-4755
US

V. Phone/Fax

Practice location:
  • Phone: 956-447-8600
  • Fax:
Mailing address:
  • Phone: 956-407-2034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141682
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: