Provider Demographics
NPI:1659704625
Name:PLIEGO, MAYRA JANNETTE (RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:JANNETTE
Last Name:PLIEGO
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2438 MONARCH DR STE A-125
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6600
Mailing Address - Country:US
Mailing Address - Phone:956-523-0966
Mailing Address - Fax:
Practice Address - Street 1:10201 MCPHERSON RD STE 300
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6880
Practice Address - Country:US
Practice Address - Phone:956-795-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ0215580OtherDPS
TXJ0215580OtherDPS