Healthcare Provider Details

I. General information

NPI: 1962218776
Provider Name (Legal Business Name): TERESA HUERTA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA MCCARTY

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 CUNNINGHAM ST
GAINESVILLE TX
76240-3546
US

IV. Provider business mailing address

728 CUNNINGHAM ST
GAINESVILLE TX
76240-3546
US

V. Phone/Fax

Practice location:
  • Phone: 940-736-7192
  • Fax:
Mailing address:
  • Phone: 940-736-7192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number893134
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: