MEDICARE: EMILY MCINTIRE

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	1040340	TX

General Provider Information

NPI Number	:	1952987141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY MCINTIRE

Provider Business Mailing Address
First Line	:	208 OAK DR S STE 502
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5789
Country	:	US
Telephone Number	:	979-297-4507
Fax Number	:	979-480-9074

Provider Business Practice Location Address
First Line	:	208 OAK DR S STE 502
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5789
Country	:	US
Telephone Number	:	979-297-4507
Fax Number	:	979-480-9074

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

Provider Enumeration Date	:	03/19/2021
Last Update Date	:	01/07/2026

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Directions to “ EMILY MCINTIRE ” Practice Location

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