Provider Demographics
NPI:1164142410
Name:COGALITO, IRIS
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:COGALITO
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 1:11200 BROADWAY ST STE 2743
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9787
Mailing Address - Country:US
Mailing Address - Phone:281-930-5119
Mailing Address - Fax:281-612-3831
Practice Address - Street 1:11200 BROADWAY ST STE 2743
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9787
Practice Address - Country:US
Practice Address - Phone:281-930-5119
Practice Address - Fax:281-612-3831
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX929991163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health