Provider Demographics
NPI:1477055713
Name:GIRON, MARISA (RN, RRT)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:
Last Name:GIRON
Suffix:
Gender:F
Credentials:RN, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 N FOSTER MALDONADO BLVD
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5893
Mailing Address - Country:US
Mailing Address - Phone:830-872-2931
Mailing Address - Fax:
Practice Address - Street 1:869 KIFURI ST
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5133
Practice Address - Country:US
Practice Address - Phone:210-334-5819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81711163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX821711OtherREGISTERED NURSE LICENSE