MEDICARE: FEB RAY FRAMO DEMASIADO

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	363L00000X	Nurse Practitioner	AP135075	TX
2	363LF0000X	Family Nurse Practitioner	AP135075	TX

General Provider Information

NPI Number	:	1831697622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FEB RAY FRAMO DEMASIADO

Provider Business Mailing Address
First Line	:	PO BOX 243
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77492-0243
Country	:	US
Telephone Number	:	281-712-4722
Fax Number	:	281-712-4723

Provider Business Practice Location Address
First Line	:	9114 MCPHERSON RD STE 2508
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6511
Country	:	US
Telephone Number	:	956-568-3638
Fax Number	:	956-568-3665

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

Provider Enumeration Date	:	01/26/2018
Last Update Date	:	04/15/2019

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