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General NPI Number Information
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NPI Number | 1972189371
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Entity Type | Organization
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Legal Business Name | RGV VAX, LLC
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 2606 E BUSINESS 83 STE 1
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City | WESLACO
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State | TX
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Zip | 78596-5139
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Country | US
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Telephone | 956-739-8788
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Fax |
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Provider Business Mailing Address
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Address Line | 2606 E BUSINESS 83 STE 1
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City | WESLACO
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State | TX
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Zip | 78596-5139
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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 | NURSE PRACTITIONER
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Name | MONICA HERNADEZ
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Credential | NP
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Telephone | 956-739-8788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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