Provider Demographics
NPI:1194344952
Name:JAUCIAN, JOHN ANGELO (RN)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ANGELO
Last Name:JAUCIAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12513 FLORAL PARK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6419
Mailing Address - Country:US
Mailing Address - Phone:516-808-5086
Mailing Address - Fax:
Practice Address - Street 1:12513 FLORAL PARK LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-6419
Practice Address - Country:US
Practice Address - Phone:516-808-5086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX873858163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty