Provider Demographics
NPI:1477195527
Name:HERRERA, MARLENE (NP-C)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARLENE
Other - Middle Name:
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:3338 OAKWELL CT STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3087
Mailing Address - Country:US
Mailing Address - Phone:210-822-3646
Mailing Address - Fax:210-822-5242
Practice Address - Street 1:11907 US HIGHWAY 87 W
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121
Practice Address - Country:US
Practice Address - Phone:830-253-1216
Practice Address - Fax:210-822-5242
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143177363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily