Provider Demographics
NPI:1912555244
Name:SCHUBERT, DELORES BUCHANAN (RN)
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:BUCHANAN
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEE
Other - Middle Name:
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4030 HIGHWAY 6 S STE 150
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-1808
Mailing Address - Country:US
Mailing Address - Phone:979-431-3380
Mailing Address - Fax:
Practice Address - Street 1:4030 HIGHWAY 6 S STE 150
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-1808
Practice Address - Country:US
Practice Address - Phone:979-431-3380
Practice Address - Fax:979-690-1008
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237599163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse