Provider Demographics
NPI:1104282243
Name:TOTALLY ABOUT YOU
Entity type:Organization
Organization Name:TOTALLY ABOUT YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-495-3573
Mailing Address - Street 1:2330 VERNA LEE BLVD
Mailing Address - Street 2:STE 109
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2838
Mailing Address - Country:US
Mailing Address - Phone:254-393-0200
Mailing Address - Fax:
Practice Address - Street 1:2330 VERNA LEE BLVD
Practice Address - Street 2:STE 109
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2838
Practice Address - Country:US
Practice Address - Phone:254-393-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty