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General NPI Number Information
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NPI Number | 1245895275
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Entity Type | Individual
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Provider Name | ANITA RAQUEL PADILLA PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 1005 CONGRESS AVE STE 925-B72
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City | AUSTIN
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State | TX
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Zip | 78701-2463
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Country | US
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Telephone | 361-585-9497
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Fax | 361-724-3322
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Provider Business Mailing Address
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Address Line | PO BOX 271943
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City | CORPUS CHRISTI
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State | TX
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Zip | 78427-1943
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Country | US
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Telephone | 361-453-6990
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Fax | 361-724-3322
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP141538
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License Number State | TX
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