Provider Demographics
NPI:1245895275
Name:PADILLA, ANITA RAQUEL (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:RAQUEL
Last Name:PADILLA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271943
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78427-1943
Mailing Address - Country:US
Mailing Address - Phone:361-453-6990
Mailing Address - Fax:361-724-3322
Practice Address - Street 1:1005 CONGRESS AVE STE 925-B72
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2463
Practice Address - Country:US
Practice Address - Phone:361-585-9497
Practice Address - Fax:361-724-3322
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141538363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health