Organization
PRESTIGE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA L FLEENOR RN, MSN, FNP-BC (CEO)
(806) 470-5450
Entity
Organization
Contact information
Practice address
4235 FERNSIDE DR, PASADENA, TX 77505-4226
(806) 470-5450
Mailing address
4235 FERNSIDE DR, PASADENA, TX 77505-4226
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
706578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457789497
INDIVIDUAL NPI
TX
Enumeration date
01/08/2014
Last updated
01/08/2014
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