MEDICARE: MR. REGINALD G WHITTINGTON FNP-BC

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	363LF0000X	Family Nurse Practitioner	AP124325	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396179396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. REGINALD G WHITTINGTON FNP-BC

Provider Business Mailing Address
First Line	:	14311 FLORET ESTATES CT
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-4585
Country	:	US
Telephone Number	:	281-450-9783
Fax Number	:

Provider Business Practice Location Address
First Line	:	5815 ANTOINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4417
Country	:	US
Telephone Number	:	832-927-6136
Fax Number	:

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

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	01/07/2025

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