Healthcare Provider Details

I. General information

NPI: 1467876664
Provider Name (Legal Business Name): ADRIANA ISAZA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2014
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 W 20TH ST STE 400
HOUSTON TX
77008-2430
US

IV. Provider business mailing address

427 W 20TH ST STE 400
HOUSTON TX
77008-2430
US

V. Phone/Fax

Practice location:
  • Phone: 713-868-4433
  • Fax: 713-868-4747
Mailing address:
  • Phone: 713-868-4433
  • Fax: 713-868-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number695985
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP125058
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: