Provider Demographics
NPI:1053166231
Name:CORREIA, RUI PAULO (APRN-CNP)
Entity type:Individual
Prefix:
First Name:RUI
Middle Name:PAULO
Last Name:CORREIA
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 W CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-9022
Mailing Address - Country:US
Mailing Address - Phone:409-782-5479
Mailing Address - Fax:
Practice Address - Street 1:1495 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1345
Practice Address - Country:US
Practice Address - Phone:419-832-8338
Practice Address - Fax:409-832-0976
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1129700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner