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Individual
MR. VICTOR LEE ILOG
Active
Individual
MR. VICTOR LEE ILOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
G-1916
NM
363LF0000X
Family Nurse Practitioner
AP136515
TX
363LF0000X
Family Nurse Practitioner
CNP-03539
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP136515
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
CNP-03539
NM
Other
Enumeration date
02/12/2018
Last updated
04/13/2026
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