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General NPI Number Information
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NPI Number | 1548527120
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Entity Type | Organization
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Legal Business Name | ANGELINA O2 TESTING LLC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 239 E QUITMAN ST STE B2
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City | EMORY
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State | TX
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Zip | 75440-2623
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Country | US
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Telephone | 844-805-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 239 E QUITMAN ST STE B2
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City | EMORY
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State | TX
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Zip | 75440-2623
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Country | US
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Telephone | 844-805-4455
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Fax |
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Authorized Official
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Title or Position | RESPIRATORY THERAPIST, MANAGER
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Name | MS. DAWN WRIGHT
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Credential | CRT
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Telephone | 903-473-8789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 63241
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License Number State | TX
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