Provider Demographics
NPI:1356026801
Name:ALBERT, REGINA DENISE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:DENISE
Last Name:ALBERT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S EGRET BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2682
Mailing Address - Country:US
Mailing Address - Phone:409-761-0166
Mailing Address - Fax:
Practice Address - Street 1:3202 111TH ST N
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-9139
Practice Address - Country:US
Practice Address - Phone:140-976-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX669725163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice