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General NPI Number Information
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NPI Number | 1700960556
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Entity Type | Individual
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Provider Name | MARIANA LUYANDO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 3675 BOCA CHICA BLVD STE E
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City | BROWNSVILLE
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State | TX
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Zip | 78521-4484
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Country | US
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Telephone | 956-542-2273
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Fax | 956-542-3730
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Provider Business Mailing Address
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Address Line | 28 SHORELINE DR
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3606
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Country | US
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Telephone | 956-204-4890
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA02415
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License Number State | TX
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