Provider Demographics
NPI:1629815477
Name:ANZALDUA, STEVEN JUAQUIN (FNP)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JUAQUIN
Last Name:ANZALDUA
Suffix:
Gender:M
Credentials:FNP
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 850
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78333-0850
Mailing Address - Country:US
Mailing Address - Phone:361-664-0303
Mailing Address - Fax:866-845-0933
Practice Address - Street 1:2701 MORGAN AVENUE
Practice Address - Street 2:STE 400
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1848
Practice Address - Country:US
Practice Address - Phone:361-664-0303
Practice Address - Fax:866-845-0933
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily