Provider Demographics
NPI:1265473771
Name:HUBER, NELDA (PA-C)
Entity type:Individual
Prefix:
First Name:NELDA
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N ESPLANADE ST
Mailing Address - Street 2:STE 102
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-4727
Mailing Address - Country:US
Mailing Address - Phone:361-275-3561
Mailing Address - Fax:
Practice Address - Street 1:2500 N ESPLANADE ST
Practice Address - Street 2:STE 101
Practice Address - City:CUERO
Practice Address - State:TX
Practice Address - Zip Code:77954-4723
Practice Address - Country:US
Practice Address - Phone:361-275-2381
Practice Address - Fax:361-275-2431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02283363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant