Provider Demographics
NPI:1629072483
Name:TAGLE, MONICA V (RNC, MSN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:V
Last Name:TAGLE
Suffix:
Gender:F
Credentials:RNC, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6418 ECKHERT RD APT 12219
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3059
Mailing Address - Country:US
Mailing Address - Phone:210-685-1054
Mailing Address - Fax:
Practice Address - Street 1:24200 IH 10 W STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1150
Practice Address - Country:US
Practice Address - Phone:210-263-9443
Practice Address - Fax:726-999-2625
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX608549363LP0200X
TXAP111865363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics