MEDICARE: VICTORIANO BAYOBAY PARILLA RN, BSN, RNFA

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	163WR0006X	Registered Nurse First Assistant	775276	TX

General Provider Information

NPI Number	:	1528491560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIANO BAYOBAY PARILLA RN, BSN, RNFA

Provider Business Mailing Address
First Line	:	412 ROUNDROCK LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76140-6547
Country	:	US
Telephone Number	:	817-886-3466
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 ROUNDROCK LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76140-6547
Country	:	US
Telephone Number	:	817-886-3466
Fax Number	:

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

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	08/13/2013

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