Provider Demographics
NPI:1427715549
Name:PADILLA, VERONICA (FNP)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 W HAMMOND ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1542
Mailing Address - Country:US
Mailing Address - Phone:214-200-1409
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD STOP 8574
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7224
Practice Address - Country:US
Practice Address - Phone:214-645-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily