1346678232 NPI number — MRS. JESSICA ROEHRICK VENTO FNP

Table of content: MRS. JESSICA ROEHRICK VENTO FNP (NPI 1346678232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346678232 NPI number — MRS. JESSICA ROEHRICK VENTO FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VENTO
Provider First Name:
JESSICA
Provider Middle Name:
ROEHRICK
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROEHRICK
Provider Other First Name:
JESSICA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346678232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9055 KATY FWY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-1629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-461-2915
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9055 KATY FWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-461-2915
Provider Business Practice Location Address Fax Number:
713-461-5307
Provider Enumeration Date:
10/31/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  751012 , 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)