Healthcare Provider Details

I. General information

NPI: 1306737523
Provider Name (Legal Business Name): ROGER TATE APOSTOL RN, EMTP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

IV. Provider business mailing address

12065 UP RIVER RD
CORPUS CHRISTI TX
78410-3324
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1198827
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: