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NPI Code Detail

MEDICARE: VERONICA VEGA FNP

MEDICARE: VERONICA VEGA FNP
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
1363L00000XNurse Practitioner607918TX

General Provider Information

NPI Number : 1558397463
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA VEGA FNP
Provider Business Mailing Address
First Line : 1717 MAIN ST
Second Line : SUITE 5300
City : DALLAS
State : TX
Zip : 75201-4605
Country : US
Telephone Number : 214-712-2074
Fax Number : 214-712-2487
Provider Business Practice Location Address
First Line : 500 W 4TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-5059
Country : US
Telephone Number : 432-640-1190
Fax Number : 432-640-3489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 07/08/2007

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Directions to “ VERONICA VEGA FNP” Practice Location

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