Provider Demographics
NPI:1770106254
Name:KONARIK, SYBLE MELINDA
Entity type:Individual
Prefix:
First Name:SYBLE
Middle Name:MELINDA
Last Name:KONARIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-7112
Mailing Address - Country:US
Mailing Address - Phone:936-402-0365
Mailing Address - Fax:
Practice Address - Street 1:233 COUNTY ROAD 2309
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-0276
Practice Address - Country:US
Practice Address - Phone:936-402-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide