Provider Demographics
NPI:1598133282
Name:NEMETH, DENISE VERA (PA-C)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:VERA
Last Name:NEMETH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:VERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2295 MARBLE ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-3217
Mailing Address - Country:US
Mailing Address - Phone:830-325-4323
Mailing Address - Fax:
Practice Address - Street 1:2557 N VETERANS BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3356
Practice Address - Country:US
Practice Address - Phone:830-773-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant