Provider Demographics
NPI:1972732071
Name:QUESADA, JANIE
Entity Type:Individual
Prefix:MS
First Name:JANIE
Middle Name:
Last Name:QUESADA
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 1:801 N CEDRO ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4712
Mailing Address - Country:US
Mailing Address - Phone:956-472-6944
Mailing Address - Fax:956-447-8268
Practice Address - Street 1:801 N CEDRO ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4712
Practice Address - Country:US
Practice Address - Phone:956-472-6944
Practice Address - Fax:956-447-8268
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies