Provider Demographics
NPI:1033250394
Name:LOVERA, BRENDA NOEMI (RN LAC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:NOEMI
Last Name:LOVERA
Suffix:
Gender:F
Credentials:RN LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 MORGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-427-8037
Mailing Address - Fax:956-427-8107
Practice Address - Street 1:711 N L STREET
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-423-3516
Practice Address - Fax:956-427-8023
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX614287163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
X15233Medicare UPIN
TXPH0013Medicare ID - Type Unspecified