Connie Ann Mixon

Individual provider Active NPI Personal Care Attendant · Vidor, TX

NPI 1689057465 · NPPES record last updated Dec 4, 2016

Key facts

NPI
1689057465
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
990 Chestnut St
Vidor, TX 77662-4418
Phone
(281) 312-9651
NPI assigned
Jun 30, 2015
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X
Adult Companion 372600000X
Attendant Care Provider 3747A0650X
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

990 Chestnut St
Vidor, TX 77662-4418

Mailing address

990 Chestnut St
Vidor, TX 77662-4418
Phone (281) 312-9651

Other names

  • Mrs. Connie Ann Byrd Former name

Other providers in Vidor, TX

All providers in Vidor, TX · Personal Care Attendant in Texas

Sources for this page

Verify at the official NPI Registry.