Carlos J De Jesus, RN

Individual provider Active NPI Registered Nurse · Devine, TX

NPI 1245778588 · NPPES record last updated Feb 7, 2017

Key facts

NPI
1245778588
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
799225 (TX)
Practice address
225 Harralton Cir
Devine, TX 78016-2301
Phone
(210) 238-1919
NPI assigned
Feb 7, 2017
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

LicenseStateTypeSpecialty
799225TXMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 799225 TX Yes

Addresses

Primary practice location

225 Harralton Cir
Devine, TX 78016-2301

Mailing address

225 Harralton Cir
Devine, TX 78016-2301
Phone (210) 238-1919

Other providers in Devine, TX

All providers in Devine, TX · Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.