1932396629 NPI number — MRS. PATRICE ELIZABETH KING RN, BSN

Table of content: MRS. PATRICE ELIZABETH KING RN, BSN (NPI 1932396629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932396629 NPI number — MRS. PATRICE ELIZABETH KING RN, BSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KING
Provider First Name:
PATRICE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, BSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PANULA
Provider Other First Name:
PATRICE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932396629
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7400 MERTON MINTER ST
Provider Second Line Business Mailing Address:
SPINAL CORD INJURY 617-128
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229-4404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-617-5300
Provider Business Mailing Address Fax Number:
210-949-3327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7400 MERTON MINTER ST
Provider Second Line Business Practice Location Address:
SPINAL CORD INJURY 617-128
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-617-5300
Provider Business Practice Location Address Fax Number:
210-949-3327
Provider Enumeration Date:
09/27/2007

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: 163WR0400X , with the licence number:  595474 , 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)





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