Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Aug 16, 2016
License(s)
AP131718 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 392929 | Pittsburgh, PA 15251-9900 | 713-461-2915 |
| LOCATION | 24917 FM 1314 RD | Porter, TX 77365-4982 | 713-461-2915 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.