Provider Demographics
NPI:1750812053
Name:PENA, VICTOR (PA)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:PENA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1901 S 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6533
Mailing Address - Country:US
Mailing Address - Phone:956-289-7000
Mailing Address - Fax:956-289-7257
Practice Address - Street 1:103 N LOOP 499
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-2557
Practice Address - Country:US
Practice Address - Phone:956-364-6500
Practice Address - Fax:956-289-7257
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2023-09-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant