MEDICARE: VERONICA ROJAS R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	663382	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	663382	OTHER	TX	R.N. LICENSE NUMBER

General Provider Information

NPI Number	:	1104086081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA ROJAS R.N.

Provider Business Mailing Address
First Line	:	4201 BONNIE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-1439
Country	:	US
Telephone Number	:	817-727-3412
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 BONNIE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-1439
Country	:	US
Telephone Number	:	817-727-3412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	06/13/2008

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