1033134747 NPI number — MR. JUAN FRANCISCO QUINTANA CRNA

Table of content: MR. JUAN FRANCISCO QUINTANA CRNA (NPI 1033134747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033134747 NPI number — MR. JUAN FRANCISCO QUINTANA CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINTANA
Provider First Name:
JUAN
Provider Middle Name:
FRANCISCO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033134747
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8322 ESTATE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAREDO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78045-8136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-767-0350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
719 W COKE RD
Provider Second Line Business Practice Location Address:
PRESBYTERIAN HOSPITAL WINNSBORO
Provider Business Practice Location Address City Name:
WINNSBORO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-342-5227
Provider Business Practice Location Address Fax Number:
903-342-4121
Provider Enumeration Date:
07/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  53446/048692 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)