Provider Demographics
NPI:1801144886
Name:SOBREVILLA, CLAUDIA EDITH (PA-C)
Entity type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:EDITH
Last Name:SOBREVILLA
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 1:6817 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-7513
Mailing Address - Country:US
Mailing Address - Phone:956-457-7744
Mailing Address - Fax:
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2725
Practice Address - Country:US
Practice Address - Phone:956-460-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07840363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical