Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 33917 | TX |
Y | 103T00000X | Psychologist | 33917 | TX |
N | 103G00000X | Clinical Psychologist | 33917 | TX |
N | 103TC0700X | Clinical Psychologist | 33917 | TX |
NPI | 1013232081 |
---|---|
Provider Name | Dr. Vittorio T Puente |
First Address | Pharr, TX 78577-2141 |
Second Address | Pharr, TX 78577-2141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2010 |
Last Update Date | 20/10/2020 |