Provider Demographics
NPI:1346563376
Name:VEGA, ISRAEL (DNP, FNP, BC)
Entity Type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:
Last Name:VEGA
Suffix:
Gender:M
Credentials:DNP, 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 2188
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-0021
Mailing Address - Country:US
Mailing Address - Phone:956-276-4560
Mailing Address - Fax:956-276-4561
Practice Address - Street 1:1795 W US HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4153
Practice Address - Country:US
Practice Address - Phone:956-276-4560
Practice Address - Fax:956-276-4561
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX669581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily