Provider Demographics
NPI:1245980226
Name:AMADO, JEROME (RN)
Entity type:Individual
Prefix:MR
First Name:JEROME
Middle Name:
Last Name:AMADO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27415 GRAYSON GAP CT
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-2087
Mailing Address - Country:US
Mailing Address - Phone:832-451-6713
Mailing Address - Fax:281-396-4705
Practice Address - Street 1:27415 GRAYSON GAP CT
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-2087
Practice Address - Country:US
Practice Address - Phone:832-451-6713
Practice Address - Fax:281-396-4705
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX732101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse