Provider Demographics
NPI:1396885778
Name:BRET WORLEY
Entity type:Organization
Organization Name:BRET WORLEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO- OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROMY
Authorized Official - Middle Name:NICOL
Authorized Official - Last Name:SATERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-334-9944
Mailing Address - Street 1:4455 S PADRE ISLAND DR
Mailing Address - Street 2:STE. 46
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5101
Mailing Address - Country:US
Mailing Address - Phone:361-334-9944
Mailing Address - Fax:
Practice Address - Street 1:4455 S PADRE ISLAND DR
Practice Address - Street 2:STE. 46
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5101
Practice Address - Country:US
Practice Address - Phone:361-334-9944
Practice Address - Fax:361-334-9963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5896440001Medicare NSC