Provider Demographics
NPI:1316044753
Name:CONTRERAS, ROGELIO (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ROGELIO
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:MSN, APRN, 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 78
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-0078
Mailing Address - Country:US
Mailing Address - Phone:956-487-0453
Mailing Address - Fax:956-487-6190
Practice Address - Street 1:128 N FM 3167
Practice Address - Street 2:RHC
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582
Practice Address - Country:US
Practice Address - Phone:956-487-0453
Practice Address - Fax:956-487-6190
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX365959ZJJEMedicare Oscar/Certification