Provider Demographics
NPI:1023172715
Name:EMMANUEL, VICTORIA N (RN)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:N
Last Name:EMMANUEL
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 1:1614 TIMBER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4563
Mailing Address - Country:US
Mailing Address - Phone:281-835-4705
Mailing Address - Fax:
Practice Address - Street 1:11000 FONDREN RD
Practice Address - Street 2:SUITE B101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5513
Practice Address - Country:US
Practice Address - Phone:713-776-2245
Practice Address - Fax:713-776-2406
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator