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General NPI Number Information
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NPI Number | 1396441036
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Entity Type | Individual
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Provider Name | LAURA ELLEN VAN TILBURG PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 5423 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-9183
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Country | US
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Telephone | 956-362-7080
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Fax | 956-362-7094
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Provider Business Mailing Address
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Address Line | PO BOX 4624
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City | MCALLEN
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State | TX
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Zip | 78502-4624
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Country | US
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Telephone | 956-362-7080
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Fax | 956-362-7094
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA16418
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License Number State | TX
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