1235113564 NPI number — NURSES UNLIMITED INC

Table of content: (NPI 1235113564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235113564 NPI number — NURSES UNLIMITED INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NURSES UNLIMITED INC
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:
Provider Other Organization Name Type Code:
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:
1235113564
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/13/2007
NPI Reactivation Date:
07/31/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4534
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ODESSA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79760-4534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
432-580-2085
Provider Business Mailing Address Fax Number:
432-580-2080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4242 WOODCOCK DR
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-732-4184
Provider Business Practice Location Address Fax Number:
210-732-4281
Provider Enumeration Date:
11/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GRISSOM
Authorized Official First Name:
JANET
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
432-580-2000

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 003467 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 001001204 . This is a "TDADS PHC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001012988 . This is a "TDADS MDCP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000963100 . This is a "TDADS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000089700 . This is a "TDADS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001001205 . This is a "TDADS CBA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001002110 . This is a "TDADS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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