Provider Demographics
NPI:1033756705
Name:ALONZO, ADELITA
Entity Type:Individual
Prefix:
First Name:ADELITA
Middle Name:
Last Name:ALONZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3881 E FM 2273
Mailing Address - Street 2:
Mailing Address - City:MAY
Mailing Address - State:TX
Mailing Address - Zip Code:76857-2902
Mailing Address - Country:US
Mailing Address - Phone:325-642-1941
Mailing Address - Fax:
Practice Address - Street 1:3881 E FM 2273
Practice Address - Street 2:
Practice Address - City:MAY
Practice Address - State:TX
Practice Address - Zip Code:76857-2902
Practice Address - Country:US
Practice Address - Phone:325-642-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX706838163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse