Basic Information
Provider Information
NPI: 1194233700
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARJONA
FirstName: ANGEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1701 W SIOUX RD APT 3103
Address2:  
City: PHARR
State: TX
PostalCode: 785779939
CountryCode: US
TelephoneNumber: 9568628572
FaxNumber:  
Practice Location
Address1: 5501 S MCCOLL RD
Address2:  
City: EDINBURG
State: TX
PostalCode: 785395503
CountryCode: US
TelephoneNumber: 9563628677
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/17/2018
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XAP136219TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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