Provider Demographics
NPI:1407419146
Name:ZUNIGA, MARISOL CRISTAL
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:CRISTAL
Last Name:ZUNIGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:FALFURRIAS
Mailing Address - State:TX
Mailing Address - Zip Code:78355-3112
Mailing Address - Country:US
Mailing Address - Phone:361-207-0504
Mailing Address - Fax:
Practice Address - Street 1:312 W 13TH ST
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355-3112
Practice Address - Country:US
Practice Address - Phone:361-207-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336549164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse