Provider Demographics
NPI:1285992933
Name:DONNA DENISE RANGEL
Entity type:Organization
Organization Name:DONNA DENISE RANGEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-891-1379
Mailing Address - Street 1:10136 CHAPEL SPRINGS TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-1241
Mailing Address - Country:US
Mailing Address - Phone:817-891-1379
Mailing Address - Fax:
Practice Address - Street 1:15435 WHITE SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-9283
Practice Address - Country:US
Practice Address - Phone:817-891-1379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services