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General NPI Number Information
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NPI Number | 1376365213
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Entity Type | Individual
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Provider Name | QUEANA SHORT
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Gender | Female
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2505 E ARKANSAS LN
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City | ARLINGTON
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State | TX
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Zip | 76010-0212
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Country | US
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Telephone | 682-999-7565
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Fax |
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Provider Business Mailing Address
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Address Line | 337 KENNEDALE SUBLETT RD APT 2107
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City | KENNEDALE
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State | TX
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Zip | 76060-2430
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Country | US
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Telephone | 580-350-0102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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