Provider Demographics
NPI:1699486795
Name:MAY, VIRDELL
Entity type:Individual
Prefix:
First Name:VIRDELL
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 JAMES FARMER ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-5143
Mailing Address - Country:US
Mailing Address - Phone:817-627-5252
Mailing Address - Fax:
Practice Address - Street 1:1901 GRAFTON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-4960
Practice Address - Country:US
Practice Address - Phone:817-627-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care