Provider Demographics
NPI:1851096705
Name:NAZARIO, VICENTE JOSE JR
Entity Type:Individual
Prefix:MR
First Name:VICENTE
Middle Name:JOSE
Last Name:NAZARIO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 CONNORS LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-3040
Mailing Address - Country:US
Mailing Address - Phone:817-513-9405
Mailing Address - Fax:
Practice Address - Street 1:5435 CONNORS LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-3040
Practice Address - Country:US
Practice Address - Phone:817-513-9405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility