Provider Demographics
NPI:1851984728
Name:QUINTANILLA, NUBIA
Entity Type:Individual
Prefix:
First Name:NUBIA
Middle Name:
Last Name:QUINTANILLA
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 1:1101 GREENBRIAR AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-1135
Mailing Address - Country:US
Mailing Address - Phone:956-222-8110
Mailing Address - Fax:
Practice Address - Street 1:1101 GREENBRIAR AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-1135
Practice Address - Country:US
Practice Address - Phone:956-222-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health