Provider Demographics
NPI:1770760183
Name:CORTEZ, ESTELA (LVN)
Entity type:Individual
Prefix:
First Name:ESTELA
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ESTELA
Other - Middle Name:
Other - Last Name:AFANADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 N BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-2706
Mailing Address - Country:US
Mailing Address - Phone:512-392-7104
Mailing Address - Fax:512-936-5942
Practice Address - Street 1:819 WATER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5333
Practice Address - Country:US
Practice Address - Phone:830-258-5430
Practice Address - Fax:830-792-5771
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92423164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX92423OtherLVN LICNESE