Healthcare Provider Details

I. General information

NPI: 1578569158
Provider Name (Legal Business Name): FE DEERE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 CANTWELL LN
CORPUS CHRISTI TX
78408-2605
US

IV. Provider business mailing address

4838 HOLLY RD STE 201
CORPUS CHRISTI TX
78411-4754
US

V. Phone/Fax

Practice location:
  • Phone: 361-882-4284
  • Fax:
Mailing address:
  • Phone: 361-991-9021
  • Fax: 361-991-9162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCIS E DEERE
Title or Position: PRESIDENT
Credential:
Phone: 361-991-9021