Individual provider Active NPI

Mayra Vlasac, BSN,RN

  • Registered Nurse
  • La Grange, TX
National Provider Identifier
1205494507
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
930051 Issued in TX
Practice address
961 E Pearl St
La Grange, TX 78945-2056
Phone
(979) 250-3224
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 930051 TX Primary

Addresses

Primary practice location

961 E Pearl St
La Grange, TX 78945-2056

Mailing address

961 E Pearl St
La Grange, TX 78945-2056

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
930051TXMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1205494507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 E PEARL ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789452056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 E PEARL ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789452056",
            "telephone_number": "979-250-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLASAC",
        "first_name": "MAYRA",
        "credential": "BSN,RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "930051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.