Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP132491 | TX |
NPI | 1003368382 |
---|---|
Provider Name | Yanet Leija |
First Address | Edinburg, TX 78539-2704 |
Second Address | Edinburg, TX 78539-2704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2016 |
Last Update Date | 02/05/2017 |