Provider Demographics
NPI:1487034914
Name:VADAKEL, CLARET
Entity Type:Individual
Prefix:
First Name:CLARET
Middle Name:
Last Name:VADAKEL
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 1:4018 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-2110
Mailing Address - Country:US
Mailing Address - Phone:813-766-4809
Mailing Address - Fax:
Practice Address - Street 1:4018 CARRINGTON DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-2110
Practice Address - Country:US
Practice Address - Phone:813-766-4809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX876188163W00000X
FLRN9252487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse