Provider Demographics
NPI:1326376864
Name:ENSMINGER, REGINALD (RN CSA)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:
Last Name:ENSMINGER
Suffix:
Gender:M
Credentials:RN CSA
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:
Other - Last Name:ENSMINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN CSA
Mailing Address - Street 1:4619 HERITAGE COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2981
Mailing Address - Country:US
Mailing Address - Phone:832-385-0290
Mailing Address - Fax:
Practice Address - Street 1:4619 HERITAGE COUNTRY LN
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2981
Practice Address - Country:US
Practice Address - Phone:832-385-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX620832163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant