Provider Demographics
NPI:1134580277
Name:FILICE, MARY ESTHER (BSN, RNFA, CNOR)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ESTHER
Last Name:FILICE
Suffix:
Gender:F
Credentials:BSN, RNFA, CNOR
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ESTHER
Other - Last Name:PARADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN,RNFA, CNOR
Mailing Address - Street 1:1709 LAGONDA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76164-8836
Mailing Address - Country:US
Mailing Address - Phone:817-721-0869
Mailing Address - Fax:
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-702-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX779467163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant