Provider Demographics
NPI:1508825225
Name:MARISCAL, BARBARA G (RN, PNP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:G
Last Name:MARISCAL
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4499 MEDICAL DR
Mailing Address - Street 2:SUITE 347
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3735
Mailing Address - Country:US
Mailing Address - Phone:210-615-8757
Mailing Address - Fax:210-615-8789
Practice Address - Street 1:4499 MEDICAL DR
Practice Address - Street 2:SUITE 347
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3735
Practice Address - Country:US
Practice Address - Phone:210-615-8757
Practice Address - Fax:210-615-8789
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX598240363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D1647Medicare ID - Type Unspecified
TXP14522Medicare UPIN
TX00911KMedicare ID - Type UnspecifiedGROUP #