Provider Demographics
NPI:1871023994
Name:TEXADA, NANCY BASS
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:BASS
Last Name:TEXADA
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 1:525 S BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6815
Mailing Address - Country:US
Mailing Address - Phone:337-237-2090
Mailing Address - Fax:337-237-2083
Practice Address - Street 1:525 SOUTH BUCHANAN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501
Practice Address - Country:US
Practice Address - Phone:337-237-2090
Practice Address - Fax:337-237-2083
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health