Provider Demographics
NPI:1063038503
Name:COMPLE, ALAN (RN)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:COMPLE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 FAIRMONT PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3306
Mailing Address - Country:US
Mailing Address - Phone:713-569-3961
Mailing Address - Fax:
Practice Address - Street 1:4300 FAIRMONT PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3306
Practice Address - Country:US
Practice Address - Phone:713-569-3961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-21
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX768246163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
02079503OtherTEXAS DL