Provider Demographics
NPI:1447698329
Name:VISCON, SANDRA MARIA (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIA
Last Name:VISCON
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:GAYTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3051 N ZARAGOZA RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-7921
Mailing Address - Country:US
Mailing Address - Phone:915-401-8019
Mailing Address - Fax:915-577-8224
Practice Address - Street 1:3051 N ZARAGOZA RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-7921
Practice Address - Country:US
Practice Address - Phone:915-401-8019
Practice Address - Fax:915-401-8096
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX640371363LF0000X
TXAP123859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX640371OtherTX BOARD OF NURSES