Provider Demographics
NPI:1376855122
Name:VAIL, ARNICO (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ARNICO
Middle Name:
Last Name:VAIL
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W ENNIS AVE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-3736
Mailing Address - Country:US
Mailing Address - Phone:972-875-1010
Mailing Address - Fax:972-875-7850
Practice Address - Street 1:900 W ENNIS AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-3736
Practice Address - Country:US
Practice Address - Phone:972-875-1010
Practice Address - Fax:972-875-7850
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX772273363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics