Provider Demographics
NPI:1184865107
Name:ALCALA, SHIRLINA LIA (NP)
Entity Type:Individual
Prefix:
First Name:SHIRLINA
Middle Name:LIA
Last Name:ALCALA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHIRLINA
Other - Middle Name:LIA
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:200 POCAHONTAS TRAIL
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-0593
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5031
Practice Address - Street 1:9870 GATEWAY BLVD N
Practice Address - Street 2:SUITE B7
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4425
Practice Address - Country:US
Practice Address - Phone:915-751-5245
Practice Address - Fax:915-751-5255
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2898397-02Medicaid