Provider Demographics
NPI:1386897106
Name:FREEL, JANICE MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:MARIE
Last Name:FREEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25002 IBERIS MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5612
Mailing Address - Country:US
Mailing Address - Phone:281-516-3831
Mailing Address - Fax:281-516-7716
Practice Address - Street 1:25002 IBERIS MEADOWS DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5612
Practice Address - Country:US
Practice Address - Phone:281-516-3831
Practice Address - Fax:281-516-7716
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525361171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183191901Medicaid