=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689847196
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INFANT RESOURCES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2008
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1679 W NORTHWEST HWY
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-310-0321
-----------------------------------------------------
Fax | 817-310-0266
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1679 W NORTHWEST HWY
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-310-0321
-----------------------------------------------------
Fax | 817-310-0266
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | DR. JANET KINNEY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 817-310-0321
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------