Individual
REGINALD J NAZAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
3304 BALBOA WAY, ROUND ROCK, TX 78665-2252
(512) 600-3383
(512) 856-9483
Mailing address
3304 BALBOA WAY, ROUND ROCK, TX 78665
(512) 573-0929
(512) 856-9483
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
9600544
FL
164W00000X
Licensed Practical Nurse
336043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34669471
DRIVER LICENSE
TX
Enumeration date
04/24/2017
Last updated
09/02/2022
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