Provider Demographics
NPI:1568604015
Name:VRL INC
Entity Type:Organization
Organization Name:VRL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE FIRST ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LONGORIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN CNOR RNFA
Authorized Official - Phone:361-664-9540
Mailing Address - Street 1:1200 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4300
Mailing Address - Country:US
Mailing Address - Phone:361-664-9540
Mailing Address - Fax:361-661-8068
Practice Address - Street 1:2500 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4169
Practice Address - Country:US
Practice Address - Phone:361-661-8183
Practice Address - Fax:361-661-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX596653163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty