Healthcare Provider Details

I. General information

NPI: 1114549912
Provider Name (Legal Business Name): ELIAS FELIX CORTEZ-GUADIANA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11920 ASTORIA BLVD STE 320
HOUSTON TX
77089-6097
US

IV. Provider business mailing address

11920 ASTORIA BLVD STE 320
HOUSTON TX
77089-6097
US

V. Phone/Fax

Practice location:
  • Phone: 281-484-9369
  • Fax:
Mailing address:
  • Phone: 281-484-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP145834
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: