Basic Information
| Provider Information | |||||||||
| NPI: | 1770063679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIANCHI | ||||||||
| FirstName: | LEDIA | ||||||||
| MiddleName: | SUSANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 MIRASOL DR | ||||||||
| Address2: | |||||||||
| City: | SANDIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3612071452 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4444 CORONA DRIVE | ||||||||
| Address2: | SUITE 144 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618541110 | ||||||||
| FaxNumber: | 8554489769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2018 | ||||||||
| LastUpdateDate: | 08/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 838613 | TX | Y | Nursing Service Providers | Registered Nurse |
No ID Information.