Provider Demographics
NPI:1518850544
Name:VAZQUEZ, PRISCILA YAZMIN
Entity type:Individual
Prefix:
First Name:PRISCILA
Middle Name:YAZMIN
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 LBJ LN
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-3236
Mailing Address - Country:US
Mailing Address - Phone:737-300-5216
Mailing Address - Fax:
Practice Address - Street 1:299 LBJ LN
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-3236
Practice Address - Country:US
Practice Address - Phone:737-300-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX961877163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care