Provider Demographics
NPI:1821273020
Name:HERRERA, MAUREEN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 TEASLEY LN 200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4652
Mailing Address - Country:US
Mailing Address - Phone:940-382-9898
Mailing Address - Fax:940-383-3815
Practice Address - Street 1:4461 COIT RD STE 411
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0526
Practice Address - Country:US
Practice Address - Phone:972-377-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02882363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant