Provider Demographics
NPI:1114397411
Name:BALDIZON, EUGENIA (PNP)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:BALDIZON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:EUGENIA
Other - Last Name:BALDIZON IZQUIERDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PNP
Mailing Address - Street 1:5430 FREDERICKSBURG RD STE 508
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3561
Mailing Address - Country:US
Mailing Address - Phone:210-614-5539
Mailing Address - Fax:210-614-5548
Practice Address - Street 1:5430 FREDERICKSBURG RD STE 508
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3561
Practice Address - Country:US
Practice Address - Phone:210-614-5539
Practice Address - Fax:210-614-5548
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758894163W00000X
TXAP129308363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse