Roy Anthony Russell, RN
Individual provider Active NPI Registered Nurse · Sinton, TX
NPI 1154821155 · NPPES record last updated Feb 15, 2018
Key facts
- NPI
- 1154821155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 851633 (TX)
- Practice address
- 9127 County Road 2035
Sinton, TX 78387-5009 - Phone
- (361) 222-2077
- NPI assigned
- Feb 15, 2018
- Sex
- Male
- 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 |
|---|---|---|---|
| 851633 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 851633 | TX | Yes |
Addresses
Primary practice location
9127 County Road 2035
Sinton, TX 78387-5009
Mailing address
9127 County Road 2035
Sinton, TX 78387-5009
Phone (361) 222-2077
Other providers in Sinton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2018. 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.