Provider Demographics
NPI:1407219553
Name:GARATE, LAUREN HERNANDEZ (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:HERNANDEZ
Last Name:GARATE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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 3046
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0746
Mailing Address - Country:US
Mailing Address - Phone:956-630-4161
Mailing Address - Fax:956-664-1398
Practice Address - Street 1:416 LINDBERG AVE STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2922
Practice Address - Country:US
Practice Address - Phone:956-630-4161
Practice Address - Fax:956-664-1398
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
TXPA10421363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GK263OtherBCBS TX
TX3580987-02Medicaid
TX504612YKSJMedicare PIN