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NPI Code Detail

MEDICARE: ISAAC JENKIN TENA GONZALES RN

MEDICARE:   ISAAC JENKIN TENA GONZALES  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
1163W00000XRegistered Nurse844655TX

General Provider Information

NPI Number : 1811497522
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAAC JENKIN TENA GONZALES RN
Provider Business Mailing Address
First Line : 9809 RICHMOND AVE UNIT B14
Second Line :
City : HOUSTON
State : TX
Zip : 77042-4567
Country : US
Telephone Number : 832-296-4977
Fax Number :
Provider Business Practice Location Address
First Line : 9809 RICHMOND AVE UNIT B14
Second Line :
City : HOUSTON
State : TX
Zip : 77042-4567
Country : US
Telephone Number : 832-296-4977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2018
Last Update Date : 02/19/2018

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Directions to “ ISAAC JENKIN TENA GONZALES RN” Practice Location

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