Provider Demographics
NPI:1003041666
Name:BORREGO, MARIZU (PA-C)
Entity type:Individual
Prefix:MS
First Name:MARIZU
Middle Name:
Last Name:BORREGO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19272 STONE OAK PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3371
Mailing Address - Country:US
Mailing Address - Phone:210-265-8851
Mailing Address - Fax:210-265-8855
Practice Address - Street 1:19272 STONE OAK PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3371
Practice Address - Country:US
Practice Address - Phone:210-265-8851
Practice Address - Fax:210-265-8855
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA-05816363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant