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General NPI Number Information
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NPI Number | 1558640599
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Entity Type | Organization
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Legal Business Name | WAYNE BELAIRE ENTERPRISES PLLC
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 3167 MARIANNWOOD DR
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City | PORT NECHES
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State | TX
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Zip | 77651-6015
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Country | US
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Telephone | 409-626-1866
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 614
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City | PORT NECHES
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State | TX
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Zip | 77651-0614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | WAYNE BELAIRE
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Credential | RNFA
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Telephone | 409-626-1866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SM0705X
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Taxonomy Name | Medical-Surgical Clinical Nurse Specialist
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License Number | 605997
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License Number State | TX
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