Provider Demographics
NPI:1154752004
Name:ZUBIARRAIN, LIA (NP)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:
Last Name:ZUBIARRAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:PAZ
Other - Last Name:DAVALOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:328 CORAL SKY LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:914-475-2183
Mailing Address - Fax:
Practice Address - Street 1:10470 VISTA DEL SOL DR STE 102
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7928
Practice Address - Country:US
Practice Address - Phone:915-615-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX780038363LA2100X
TXAP124692363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX345644YKN5Medicare PIN