MEDICARE: MRS. FELISA DIANA LESSER NP

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	AP136940	TX

General Provider Information

NPI Number	:	1982107454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FELISA DIANA LESSER NP

Provider Business Mailing Address
First Line	:	612 W MAIN ST STE 101
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-3768
Country	:	US
Telephone Number	:	832-975-7579
Fax Number	:	832-281-0975

Provider Business Practice Location Address
First Line	:	612 W MAIN ST STE 101
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-3768
Country	:	US
Telephone Number	:	832-975-7579
Fax Number	:	832-281-0975

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

Provider Enumeration Date	:	03/12/2018
Last Update Date	:	06/18/2024

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