MEDICARE: MS. EVELYN CECILE PRICE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744R1102X	Research Study Specialist	508512	TX

General Provider Information

NPI Number	:	1427316306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EVELYN CECILE PRICE RN

Provider Business Mailing Address
First Line	:	28235 EQUESTRIAN
Second Line	:
City	:	FAIR OAKS RANCH
State	:	TX
Zip	:	78015-4656
Country	:	US
Telephone Number	:	210-698-8129
Fax Number	:	210-698-8114

Provider Business Practice Location Address
First Line	:	28235 EQUESTRIAN
Second Line	:
City	:	FAIR OAKS RANCH
State	:	TX
Zip	:	78015-4656
Country	:	US
Telephone Number	:	210-698-8129
Fax Number	:	210-698-8114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	04/27/2012

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