Provider Demographics
NPI:1629883715
Name:TAMEZ, LIZZETTE ELOISE (FNP-C)
Entity type:Individual
Prefix:
First Name:LIZZETTE
Middle Name:ELOISE
Last Name:TAMEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5711 MCPHERSON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6838
Mailing Address - Country:US
Mailing Address - Phone:956-602-8595
Mailing Address - Fax:
Practice Address - Street 1:5711 MCPHERSON RD STE 103
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6838
Practice Address - Country:US
Practice Address - Phone:956-602-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1190102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily