Tomasa Vidaurri, LVN

Individual provider Active NPI Licensed Vocational Nurse · Mathis, TX

NPI 1780187740 · NPPES record last updated Mar 15, 2018

Key facts

NPI
1780187740
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
308380 (TX)
Practice address
269 Brown LN
Mathis, TX 78368-4349
Phone
(361) 980-6037
NPI assigned
Mar 15, 2018
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
308380TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 308380 TX Yes

Addresses

Primary practice location

269 Brown LN
Mathis, TX 78368-4349

Mailing address

269 Brown LN
Mathis, TX 78368-4349
Phone (361) 980-6037

Other providers in Mathis, TX

All providers in Mathis, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.