Provider Demographics
NPI:1932479433
Name:OZUNA, ISSAC
Entity Type:Individual
Prefix:MR
First Name:ISSAC
Middle Name:
Last Name:OZUNA
Suffix:
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 1:2001 S JACKSON RD
Mailing Address - Street 2:STE A-2
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-8604
Mailing Address - Country:US
Mailing Address - Phone:956-686-1163
Mailing Address - Fax:956-686-1263
Practice Address - Street 1:2001 S JACKSON RD
Practice Address - Street 2:STE A-2
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-8604
Practice Address - Country:US
Practice Address - Phone:956-686-1163
Practice Address - Fax:956-686-1263
Is Sole Proprietor?:No
Enumeration Date:2011-12-31
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic