Individual
RITA A JEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16526 COWAN RD, SANTA FE, TX 77517-2769
(409) 789-8528
(409) 925-3904
Mailing address
PO BOX 103, SANTA FE, TX 77517-0103
(409) 789-8528
(409) 925-3904
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0041655
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016964101
—
TX
Enumeration date
12/05/2007
Last updated
01/06/2017
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