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NPI Code Detail

MEDICARE: REGENCY IHS NPS LLC

MEDICARE: REGENCY IHS NPS LLC
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
1363L00000XNurse Practitioner

General Provider Information

NPI Number : 1619432986
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGENCY IHS NPS LLC
Provider Business Mailing Address
First Line : 1908 N LAURENT ST STE 250
Second Line :
City : VICTORIA
State : TX
Zip : 77901-5417
Country : US
Telephone Number : 361-576-0694
Fax Number : 361-576-5484
Provider Business Practice Location Address
First Line : 1908 N LAURENT ST STE 250
Second Line :
City : VICTORIA
State : TX
Zip : 77901-5417
Country : US
Telephone Number : 361-576-0694
Fax Number : 361-576-5484
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : DONOVAN R DEKOWSKI
Credential :
Telephone Number : 361-576-0694
Provider Enumeration Date : 01/31/2019
Last Update Date : 03/09/2026

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Directions to “REGENCY IHS NPS LLC ” Practice Location

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