MEDICARE: MRS. DOROTHY E NELSON GNP

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	363LA2200X	Adult Health Nurse Practitioner	661624	TX

General Provider Information

NPI Number	:	1528142064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DOROTHY E NELSON GNP

Provider Business Mailing Address
First Line	:	23234 LIDSTONE POINT CT
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-3510
Country	:	US
Telephone Number	:	281-693-2375
Fax Number	:

Provider Business Practice Location Address
First Line	:	1961 W T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1256
Country	:	US
Telephone Number	:	713-225-9355
Fax Number	:	713-868-4779

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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