Healthcare Provider Details

I. General information

NPI: 1992829378
Provider Name (Legal Business Name): BRENDA NAVARRETE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W PLEASANT RUN RD SUITE 210
LANCASTER TX
75146-1079
US

IV. Provider business mailing address

506 SUNFLOWER ST
RED OAK TX
75154-4224
US

V. Phone/Fax

Practice location:
  • Phone: 972-230-8660
  • Fax: 972-230-8610
Mailing address:
  • Phone: 972-617-7905
  • Fax: 972-230-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number662171
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: