Provider Demographics
NPI:1437552171
Name:PACHUTA, CAROL J (RN)
Entity Type:Individual
Prefix:MISS
First Name:CAROL
Middle Name:J
Last Name:PACHUTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12930 EAST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5710
Mailing Address - Country:US
Mailing Address - Phone:713-453-6909
Mailing Address - Fax:713-453-7627
Practice Address - Street 1:12930 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5710
Practice Address - Country:US
Practice Address - Phone:713-453-6909
Practice Address - Fax:713-453-7627
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX439688163WM0705X, 163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic