Provider Demographics
NPI:1497233175
Name:DEOCOS, CHRISTINE JOY BANGILAN (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE JOY
Middle Name:BANGILAN
Last Name:DEOCOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISTINE JOY
Other - Middle Name:CIUDAD
Other - Last Name:BANGILAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:18 PALM DESERT DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3295
Mailing Address - Country:US
Mailing Address - Phone:832-567-6357
Mailing Address - Fax:
Practice Address - Street 1:18 PALM DESERT DR
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3295
Practice Address - Country:US
Practice Address - Phone:832-567-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX941680163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse