Healthcare Provider Details

I. General information

NPI: 1386181618
Provider Name (Legal Business Name): GEM MONIKA YAMON ESCAMILLA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8116 LONG POINT RD
HOUSTON TX
77055
US

IV. Provider business mailing address

8116 LONG POINT RD
HOUSTON TX
77055-2006
US

V. Phone/Fax

Practice location:
  • Phone: 832-566-7139
  • Fax:
Mailing address:
  • Phone: 832-566-7139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP133062
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: