Provider Demographics
NPI:1194262527
Name:PAZ, HERBERT (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:PAZ
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 S CAGE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5448
Mailing Address - Country:US
Mailing Address - Phone:956-475-3031
Mailing Address - Fax:956-475-3680
Practice Address - Street 1:1701 S CAGE BLVD STE 116
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6459
Practice Address - Country:US
Practice Address - Phone:956-702-7054
Practice Address - Fax:956-702-7054
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX391641301Medicaid