Healthcare Provider Details

I. General information

NPI: 1871638593
Provider Name (Legal Business Name): ALMA ROSA BANEGAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 N STADIUM DR 6TH FLOOR
HOUSTON TX
77054
US

IV. Provider business mailing address

PO BOX 88361 CITY OF HOUSTON HEALTH & HUMAN SERVICES
HOUSTON TX
77288-8861
US

V. Phone/Fax

Practice location:
  • Phone: 832-248-9385
  • Fax: 713-384-7752
Mailing address:
  • Phone: 713-794-9104
  • Fax: 713-798-0803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number544188
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number544188
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: