Provider Demographics
NPI:1447750765
Name:MACHAC, JULIE ANN (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MACHAC
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 RIVER RANCH NORTH DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-4479
Mailing Address - Country:US
Mailing Address - Phone:713-478-0541
Mailing Address - Fax:
Practice Address - Street 1:2600 CORDES DR STE A
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1352
Practice Address - Country:US
Practice Address - Phone:281-238-8775
Practice Address - Fax:281-491-7812
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX696549163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse