1144657693 NPI number — REGINA ROBERTSON

Table of content: (NPI 1144657693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144657693 NPI number — REGINA ROBERTSON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGINA ROBERTSON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
A NURSE'S TOUCH HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144657693
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E CAMERON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKDALE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76567-2924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-446-2009
Provider Business Mailing Address Fax Number:
512-446-3859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E CAMERON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKDALE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76567-2924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-446-2009
Provider Business Practice Location Address Fax Number:
512-446-3859
Provider Enumeration Date:
09/30/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ROBERTSON
Authorized Official First Name:
REGINA
Authorized Official Middle Name:
VILLANUEVA
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
254-563-6556

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  014635 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 74-7824 . This is a "MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com