Provider Demographics
NPI:1003473638
Name:ARTEAGA, ADOLFO (APRN-CNP)
Entity Type:Individual
Prefix:MR
First Name:ADOLFO
Middle Name:
Last Name:ARTEAGA
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:ADOLFO
Other - Middle Name:
Other - Last Name:ARTEAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ADULT GERONTOLOGY NP
Mailing Address - Street 1:PO BOX 6148
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-6148
Mailing Address - Country:US
Mailing Address - Phone:956-362-8677
Mailing Address - Fax:956-362-7253
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9152
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:956-362-7253
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141264363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX907249OtherMEDICARE
TX407033601Medicaid