Provider Demographics
NPI:1790269140
Name:VAZQUEZ, CLAUDIO GILBERTO (FNP)
Entity Type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:GILBERTO
Last Name:VAZQUEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N FM 3167
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6211
Mailing Address - Country:US
Mailing Address - Phone:956-487-0453
Mailing Address - Fax:
Practice Address - Street 1:128 N FM 3167
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6211
Practice Address - Country:US
Practice Address - Phone:956-487-0453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily