MEDICARE: MRS. BRIANNE ADDICKS ANP

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	688349	TX

General Provider Information

NPI Number	:	1790983062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIANNE ADDICKS ANP

Provider Business Mailing Address
First Line	:	13502 TOBINN MANOR DR
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-8080
Country	:	US
Telephone Number	:	713-702-0843
Fax Number	:

Provider Business Practice Location Address
First Line	:	13203 FRY RD
Second Line	:	SUITE 800
City	:	CYPRESS
State	:	TX
Zip	:	77433-3668
Country	:	US
Telephone Number	:	281-758-1022
Fax Number	:	281-758-1032

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

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	03/23/2026

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