Anna Christine Avila, RN
Individual provider Active NPI Registered Nurse · Fate, TX
NPI 1104554658 · NPPES record last updated Aug 11, 2022
Key facts
- NPI
- 1104554658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 929816 (TX)
- Practice address
- 553 La Grange Dr
Fate, TX 75087-6954 - Phone
- (469) 964-1206
- NPI assigned
- Aug 11, 2022
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 929816 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 929816 | TX | Yes |
Addresses
Primary practice location
553 La Grange Dr
Fate, TX 75087-6954
Mailing address
553 La Grange Dr
Fate, TX 75087-6954
Phone (469) 964-1206
Other providers in Fate, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.