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General NPI Number Information
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NPI Number | 1326690025
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Entity Type | Individual
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Provider Name | VERONICA GOIRENA GRANADOS FNP
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Gender | Female
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 104 WATERMARK
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City | VICTORIA
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State | TX
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Zip | 77904-1168
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Country | US
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Telephone | 361-220-7175
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Fax | 361-572-9163
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Provider Business Mailing Address
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Address Line | 611 S EAST ST
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City | EDNA
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State | TX
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Zip | 77957-3721
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Country | US
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Telephone | 361-235-2639
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP142210
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License Number State | TX
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