Provider Demographics
NPI:1437499738
Name:BAUTISTA, BEATRIZ (NP)
Entity Type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:
Last Name:BAUTISTA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S BICENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5275
Mailing Address - Country:US
Mailing Address - Phone:956-971-0077
Mailing Address - Fax:956-971-0077
Practice Address - Street 1:500 S BICENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5275
Practice Address - Country:US
Practice Address - Phone:956-971-0077
Practice Address - Fax:956-971-0077
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX501566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX501556OtherNURSE PRACTIONER LICENSE