Basic Information
Provider Information
NPI: 1437589934
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAPP
FirstName: FLORA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: QUINTANILLA
OtherFirstName: CARMENZA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 5
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124457787
FaxNumber: 5124404059
Practice Location
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124457787
FaxNumber: 5124404059
Other Information
ProviderEnumerationDate: 11/19/2013
LastUpdateDate: 11/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X796410TXY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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