Basic Information
| Provider Information | |||||||||
| NPI: | 1518540988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRIONES | ||||||||
| FirstName: | ERMINIA | ||||||||
| MiddleName: | MARGARITA | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 703 N GAINES AVE | ||||||||
| Address2: | |||||||||
| City: | TULIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790881113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8069952180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4120 22ND PL | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794101122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067933252 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2021 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2158901 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.