Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | L2817 | TX |
NPI | 1326065921 |
---|---|
Provider Name | Dr. Yvonne Eva Bracamontes |
First Address | Mcallen, TX 78504-6104 |
Second Address | Mcallen, TX 78504-6104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 09/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H73049 | (02) | TX |