Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP141264 | TX |
NPI | 1003473638 |
---|---|
Provider Name | Adolfo Arteaga |
First Address | Malvern, PA 19355-0746 |
Second Address | Mcallen, TX 78503-2932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2019 |
Last Update Date | 16/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
407033601 | (05) | TX |
907249 | MEDICARE (01) | TX |