Provider Demographics
NPI:1942960323
Name:CISNEROS, PERLA PATRICIA
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:PATRICIA
Last Name:CISNEROS
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 1:4302 S SUGAR RD STE 105
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9140
Mailing Address - Country:US
Mailing Address - Phone:956-287-3099
Mailing Address - Fax:956-517-1521
Practice Address - Street 1:4302 S SUGAR RD STE 105
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9140
Practice Address - Country:US
Practice Address - Phone:956-287-3099
Practice Address - Fax:956-517-1521
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach