Erik Blake Palacios, MBA, BSN - RN
Individual provider Active NPI Registered Nurse · Mico, TX
NPI 1235940792 · NPPES record last updated Jan 15, 2025
Key facts
- NPI
- 1235940792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1092679 (TX)
- Practice address
- 502 County Road 273
Mico, TX 78056-5330 - Phone
- (210) 454-8614
- NPI assigned
- Jan 15, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor on Science - Nursing, Master of Business Administration, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1092679 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1092679 | TX | Yes |
Addresses
Primary practice location
502 County Road 273
Mico, TX 78056-5330
Mailing address
502 County Road 273
Mico, TX 78056-5330
Phone (210) 454-8614
Other providers in Mico, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.