MEDICARE: MRS. SATAIRA NICOLE SUMMERLIN RMA, RPT

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	246RP1900X	Phlebotomy Technician		TX

General Provider Information

NPI Number	:	1699632281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SATAIRA NICOLE SUMMERLIN RMA, RPT

Provider Business Mailing Address
First Line	:	612 E HICKORY ST
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-4309
Country	:	US
Telephone Number	:	940-703-0747
Fax Number	:

Provider Business Practice Location Address
First Line	:	612 E HICKORY ST
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-4309
Country	:	US
Telephone Number	:	940-703-0747
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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