COMPLETE HEALTH CARE NPI 1316610017

NPI Information

NPI: 1316610017
Provider Name: COMPLETE HEALTH CARE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 45D2234681

Address:
2933 PARK PLAZA LN
PORT ARTHUR, TX
ZIP 77642
Phone: (409) 983-1899
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COMPLETE HEALTH CARE is a family nurse practitioner in Port Arthur, TX. COMPLETE HEALTH CARE NPI is 1316610017. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2933 PARK PLAZA LN
PORT ARTHUR, TX
ZIP 77642-516
Phone: (409) 983-1899
Fax: (409) 300-4310

The provider's authorized official is Connie D Johnson-wiltz .
The authorized official title is Owner and has the following contact phone number (409) 983-1899.

The CLIA number assigned to this NPI record is 45D2234681 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/28/2021 and was last updated on 10/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1316610017	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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