Dedra Mechelle Barajas, NURSE

Individual provider Active NPI Licensed Vocational Nurse · Alvin, TX

NPI 1063912855 · NPPES record last updated Feb 19, 2018

Key facts

NPI
1063912855
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
126035 (TX)
Practice address
1601 W Shane St
Alvin, TX 77511-3126
Phone
(281) 734-5240
NPI assigned
Feb 19, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
126035TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 126035 TX Yes

Addresses

Primary practice location

1601 W Shane St
Alvin, TX 77511-3126

Mailing address

1601 W Shane St
Alvin, TX 77511-3126
Phone (281) 734-5240

Other providers in Alvin, TX

All providers in Alvin, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.