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General NPI Number Information
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NPI Number | 1497240592
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Entity Type | Individual
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Provider Name | BIENVENIDO BUAQUEN BAQUIRIN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/30/2018
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Last Update Date | 06/30/2018
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Provider Practice Location Address
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Address Line | 520 E 6TH ST
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City | ODESSA
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State | TX
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Zip | 79761-4527
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Country | US
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Telephone | 432-582-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 HEREFORD BLVD
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City | MIDLAND
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State | TX
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Zip | 79707-9784
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Country | US
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Telephone |
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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 | AP137867
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License Number State | TX
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