=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265451645
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NURSES ALLIANCE HEALTHCRAE SERVICES, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1718 HAZYKNOLL LN
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77067-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-440-5608
-----------------------------------------------------
Fax | 281-440-5658
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1718 HAZYKNOLL LN
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77067-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-440-5608
-----------------------------------------------------
Fax | 281-440-5658
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. TISHA SANKEY
-----------------------------------------------------
Credential | RN,BSN
-----------------------------------------------------
Telephone | 281-440-5608
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BN1400X
-----------------------------------------------------
Taxonomy Name | Nursing Facility Supplies (DME)
-----------------------------------------------------
License Number | 010182
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------