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General NPI Number Information
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NPI Number | 1720924095
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Entity Type | Individual
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Provider Name | FERNANDO MANUEL JUAREZ JR.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 1937 E BUSTAMANTE ST OFC 1.1059
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City | LAREDO
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State | TX
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Zip | 78041-5416
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Country | US
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Telephone | 956-523-7413
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Fax | 210-450-2419
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Provider Business Mailing Address
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Address Line | 1937 E BUSTAMANTE ST
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City | LAREDO
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State | TX
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Zip | 78041-5416
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Country | US
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Telephone | 956-415-7722
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Fax | 210-450-2419
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 49027
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License Number State | TX
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