MEDICARE: MRS. ALIDA GARZA ESMILLA FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	822842	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	363LF0000X	Family Nurse Practitioner	AP144894	TX

General Provider Information

NPI Number	:	1164062733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALIDA GARZA ESMILLA FNP-C

Provider Business Mailing Address
First Line	:	1219 CRICKLEWOOD LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-3655
Country	:	US
Telephone Number	:	713-876-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 N SAM HOUSTON PKWY E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77032-3400
Country	:	US
Telephone Number	:	844-342-2227
Fax Number	:	713-401-9758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2020
Last Update Date	:	07/16/2023

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