Provider Demographics
NPI:1740847060
Name:ONSARE, GEOFFREY
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:ONSARE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 TAMPICO ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-3535
Mailing Address - Country:US
Mailing Address - Phone:682-561-0212
Mailing Address - Fax:
Practice Address - Street 1:1219 TAMPICO ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-3535
Practice Address - Country:US
Practice Address - Phone:682-561-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233707164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse