Provider Demographics
NPI:1497032379
Name:FUENTES, MARIA V (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:V
Last Name:FUENTES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WALTER WAGERS ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-2503
Mailing Address - Country:US
Mailing Address - Phone:956-373-5955
Mailing Address - Fax:956-969-9564
Practice Address - Street 1:1001 JAMES ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596
Practice Address - Country:US
Practice Address - Phone:956-647-8600
Practice Address - Fax:956-969-9564
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350241101Medicaid
TX435747YLPSOtherWELLMED PTAN