Provider Demographics
NPI:1881063717
Name:COREAS, ARCENIO (FNP)
Entity type:Individual
Prefix:
First Name:ARCENIO
Middle Name:
Last Name:COREAS
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 1:3507 JAIME ZAPATA MEMORIAL HWY STE 5
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-4770
Mailing Address - Country:US
Mailing Address - Phone:956-726-9252
Mailing Address - Fax:956-753-3442
Practice Address - Street 1:3507 JAIME ZAPATA MEMORIAL HWY STE 5
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-4770
Practice Address - Country:US
Practice Address - Phone:956-726-9252
Practice Address - Fax:956-753-3442
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily