=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598658312
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRU-VALUE CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2025
-----------------------------------------------------
Last Update Date | 06/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25140 KINGSLAND BLVD SUITE 200, OFFICE # 204
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-8386
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-607-9802
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4411 AVERSA DR
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77493-3809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-469-6990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALER
-----------------------------------------------------
Name | SANDRA PEREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-238-8337
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------