Individual
EUDOLIO BARRERA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
315 BRYAN LOOP, RIO GRANDE CITY, TX 78582-6887
(956) 412-3337
(956) 353-1065
Mailing address
315 BRYAN LOOP, RIO GRANDE CITY, TX 78582-6887
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
863207
TX
164X00000X
Licensed Vocational Nurse
863207
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790847531
—
TX
Enumeration date
03/28/2019
Last updated
04/08/2020
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