Provider Demographics
NPI:1871262360
Name:PIMENTEL, ALYSSA (FNP)
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4822
Mailing Address - Country:US
Mailing Address - Phone:361-664-0145
Mailing Address - Fax:361-664-2248
Practice Address - Street 1:1311 E GENERAL CAVAZOS BLVD STE 303C
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-7123
Practice Address - Country:US
Practice Address - Phone:361-592-3237
Practice Address - Fax:361-221-1856
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1053888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily