Provider Demographics
NPI:1972203263
Name:TORRES, CARMEN LUCY (RN, CCM)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:LUCY
Last Name:TORRES
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841211
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0001
Mailing Address - Country:US
Mailing Address - Phone:832-605-6571
Mailing Address - Fax:
Practice Address - Street 1:10203 BROOKSHORE LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3268
Practice Address - Country:US
Practice Address - Phone:832-605-6571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX633556163W00000X, 163WC0400X, 163WH0200X
TX49489171M00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator