Provider Demographics
NPI:1144568957
Name:BRAVO, JULIO CESAR (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JULIO
Middle Name:CESAR
Last Name:BRAVO
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5055
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0086
Mailing Address - Country:US
Mailing Address - Phone:956-600-8166
Mailing Address - Fax:956-600-8755
Practice Address - Street 1:2001 W MILE 3 RD STE 2500
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-4294
Practice Address - Country:US
Practice Address - Phone:956-600-8166
Practice Address - Fax:956-600-8755
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX751348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily