Provider Demographics
NPI:1891272134
Name:PHUCAS, PHYLLIS EILEEN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:EILEEN
Last Name:PHUCAS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44962 CARY LN
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-8900
Mailing Address - Country:US
Mailing Address - Phone:713-591-6546
Mailing Address - Fax:
Practice Address - Street 1:44962 CARY LN
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-8900
Practice Address - Country:US
Practice Address - Phone:713-591-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX419806163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse