Healthcare Provider Details

I. General information

NPI: 1790465847
Provider Name (Legal Business Name): MS. CHARITY GAIL VERRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. CHARITY GAIL WITMER

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13404 MONDOVI DR
FRISCO TX
75033-0948
US

IV. Provider business mailing address

13404 MONDOVI DR
FRISCO TX
75033-0948
US

V. Phone/Fax

Practice location:
  • Phone: 469-435-0713
  • Fax:
Mailing address:
  • Phone: 469-435-0713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: