Healthcare Provider Details

I. General information

NPI: 1114864584
Provider Name (Legal Business Name): BILLY LEDESMA FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17703 FAIRGROVE PARK DR
HOUSTON TX
77095-4274
US

IV. Provider business mailing address

17703 FAIRGROVE PARK DR
HOUSTON TX
77095-4274
US

V. Phone/Fax

Practice location:
  • Phone: 346-333-9464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1006816
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: