Provider Demographics
NPI:1780919027
Name:AVILA, JANIE MARTINEZ (RN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:MARTINEZ
Last Name:AVILA
Suffix:
Gender:
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-1139
Mailing Address - Country:US
Mailing Address - Phone:979-543-6251
Mailing Address - Fax:
Practice Address - Street 1:25000 US 59 RD
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-5478
Practice Address - Country:US
Practice Address - Phone:979-314-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678190363LF0000X
TXAP118295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210127101Medicaid
TXP01090419OtherRAILROAD MEDICARE PTAN
TX875N24OtherBC/BS#
TXP00805751OtherRAILROAD MEDICARE #
TX808N52OtherBC/BS #
TX210127103Medicaid
TXP00805751OtherRAILROAD MEDICARE #
TXTXB150792Medicare PIN