Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP141028 | TX |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP141028 | TX |
NPI | 1083272405 |
---|---|
Provider Name | Joyce Villasenor Rocha |
First Address | Dallas, TX 75391-1230 |
Second Address | Mcallen, TX 78503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2019 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
411441502 | (05) | TX |