Provider Demographics
NPI:1942802087
Name:RESENDIZ, ESTRELLA RESENDIZ (RN)
Entity Type:Individual
Prefix:
First Name:ESTRELLA
Middle Name:RESENDIZ
Last Name:RESENDIZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ANGLIN ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4102
Mailing Address - Country:US
Mailing Address - Phone:903-440-5209
Mailing Address - Fax:
Practice Address - Street 1:204 ANGLIN ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4102
Practice Address - Country:US
Practice Address - Phone:903-440-5209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010114163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse