Individual
MRS. CHANIDA GNAYONG TAUTHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2013 E GRIFFIN PKWY, MISSION, TX 78572-3222
(956) 585-4704
(956) 585-6775
Mailing address
2013 E GRIFFIN PKWY, MISSION, TX 78572-3222
(956) 585-4704
(956) 585-6775
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
600220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1711194
—
TX
Enumeration date
06/08/2006
Last updated
09/27/2023
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