Provider Demographics
NPI:1073946620
Name:BARRERA, MELINDA (FNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:BARRERA
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 1:502 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4660
Mailing Address - Country:US
Mailing Address - Phone:956-292-0100
Mailing Address - Fax:956-292-2613
Practice Address - Street 1:307 N SALINAS BLVD
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537
Practice Address - Country:US
Practice Address - Phone:956-464-2402
Practice Address - Fax:956-464-3339
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123920363LF0000X
TX771897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP123920OtherSTATE LICENSE
TX771897OtherLICENSE