Provider Demographics
NPI:1508395153
Name:LABRADOR, WERWIN (NP)
Entity Type:Individual
Prefix:
First Name:WERWIN
Middle Name:
Last Name:LABRADOR
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E. SAVANNAH AVE
Mailing Address - Street 2:BLDG B STE 203
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503
Mailing Address - Country:US
Mailing Address - Phone:956-686-7611
Mailing Address - Fax:956-618-3164
Practice Address - Street 1:110 E. SAVANNAH AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-686-7611
Practice Address - Fax:956-618-3164
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133945363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily