Individual
IVA D FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3513 W ALBERTA RD, EDINBURG, TX 78539-8466
(956) 664-9773
(956) 664-9773
Mailing address
PO BOX 720550, MCALLEN, TX 78504-0550
(956) 664-9771
(956) 664-9973
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
582381
TX
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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