Individual
CLAUDIA LICONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12813 N 106TH ST, MISSION, TX 78573-7100
(956) 222-1844
Mailing address
2609 NESSUH AVE, EDINBURG, TX 78541-4814
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
833754
TX
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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