Provider Demographics
NPI:1033685722
Name:BOBADILLA, LILIANA P
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:P
Last Name:BOBADILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLEFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79339-4810
Mailing Address - Country:US
Mailing Address - Phone:806-385-6424
Mailing Address - Fax:
Practice Address - Street 1:1600 S SUNSET AVE
Practice Address - Street 2:
Practice Address - City:LITTLEFIELD
Practice Address - State:TX
Practice Address - Zip Code:79339-4810
Practice Address - Country:US
Practice Address - Phone:806-385-6424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily