Provider Demographics
NPI:1659947877
Name:FAVARATO, GIOVANNA PAOLA
Entity Type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:PAOLA
Last Name:FAVARATO
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 1:10201 MCPHERSON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6880
Mailing Address - Country:US
Mailing Address - Phone:956-795-1160
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?:Yes
Enumeration Date:2021-05-28
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily