Provider Demographics
NPI:1427692144
Name:OBNIAL, GERARD ACHILLES MACAPAGAL (FNP)
Entity type:Individual
Prefix:MR
First Name:GERARD ACHILLES
Middle Name:MACAPAGAL
Last Name:OBNIAL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 LULA ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3401
Mailing Address - Country:US
Mailing Address - Phone:956-624-3480
Mailing Address - Fax:
Practice Address - Street 1:1400 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5668
Practice Address - Country:US
Practice Address - Phone:956-624-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily