Provider Demographics
NPI:1598305583
Name:PONCE, VERONICA N/A
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:N/A
Last Name:PONCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 BARTON ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-5702
Mailing Address - Country:US
Mailing Address - Phone:210-260-8649
Mailing Address - Fax:
Practice Address - Street 1:713 BARTON ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5702
Practice Address - Country:US
Practice Address - Phone:210-260-8649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342933164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse