MEDICARE: MRS. ESMERALDA CUNTAPAY UBINA NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1336405307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ESMERALDA CUNTAPAY UBINA NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	2705 CROSSLANDS DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-3846
Country	:	US
Telephone Number	:	972-675-8805
Fax Number	:

Provider Business Practice Location Address
First Line	:	2705 CROSSLANDS DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-3846
Country	:	US
Telephone Number	:	972-675-8805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2012
Last Update Date	:	04/04/2012

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