Healthcare Provider Details

I. General information

NPI: 1063392629
Provider Name (Legal Business Name): ISABEL TIJERINA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 10/24/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 GARTH RD
BAYTOWN TX
77521-2122
US

IV. Provider business mailing address

6927 MOONRISE LN
HOUSTON TX
77049-2531
US

V. Phone/Fax

Practice location:
  • Phone: 281-420-8600
  • Fax:
Mailing address:
  • Phone: 832-319-8860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1211899
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: