Provider Demographics
NPI:1205476280
Name:BERNAL, JUAN FRANCISCO (CSFA)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:FRANCISCO
Last Name:BERNAL
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 N 25TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4592
Mailing Address - Country:US
Mailing Address - Phone:956-225-8942
Mailing Address - Fax:
Practice Address - Street 1:900 S BRYAN RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6613
Practice Address - Country:US
Practice Address - Phone:956-323-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
193147246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant