Provider Demographics
NPI:1841545324
Name:POWER, TIMOTHY PAUL (CNA)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:PAUL
Last Name:POWER
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9903 KENTS STORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-1506
Mailing Address - Country:US
Mailing Address - Phone:325-792-7336
Mailing Address - Fax:
Practice Address - Street 1:9903 KENTS STORE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-1506
Practice Address - Country:US
Practice Address - Phone:325-792-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA8380188376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNA8380188OtherDEPARTMENT OF AGING AND DISABILITY SERVICES