Healthcare Provider Details

I. General information

NPI: 1740552389
Provider Name (Legal Business Name): BIANCA DOLORES BABER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2012
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PACKARD HALL 411 S NEDDERMAN DRIVE BOX 19407
ARLINGTON TX
76019-0407
US

IV. Provider business mailing address

PACKARD HALL 411 S NEDDERMAN DRIVE BOX 19407
ARLINGTON TX
76019-0407
US

V. Phone/Fax

Practice location:
  • Phone: 414-388-1936
  • Fax:
Mailing address:
  • Phone: 414-388-1936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number933943
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: