Basic Information
| Provider Information | |||||||||
| NPI: | 1033561279 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JULIE TABINGO CRNA PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4228 N MCCOLL RD | ||||||||
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| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785042523 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 E RIDGE RD STE 3 | ||||||||
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| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785031536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566824151 | ||||||||
| FaxNumber: | 9566824154 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2016 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | MEZA | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECT OWNER/PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 9566824151 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.