Provider Demographics
NPI:1629629803
Name:LABRADO, VICTOR (FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:LABRADO
Suffix:
Gender:M
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7434 LOUIS PASTEUR DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4587
Mailing Address - Country:US
Mailing Address - Phone:210-761-9001
Mailing Address - Fax:210-783-1139
Practice Address - Street 1:3615 RUTHERGLEN ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1416
Practice Address - Country:US
Practice Address - Phone:915-772-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1435252363LF0000X
TXAP143252363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily