Healthcare Provider Details
I. General information
NPI: 1982778098
Provider Name (Legal Business Name): KRISTI SPURELL BREAUX FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 03/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4545 POST OAK PLACE DR SUITE 130
HOUSTON TX
77027-3164
US
IV. Provider business mailing address
4545 POST OAK PLACE DR SUITE 130
HOUSTON TX
77027-3164
US
V. Phone/Fax
- Phone: 713-960-8008
- Fax: 713-960-0965
- Phone: 713-960-8008
- Fax: 713-960-0965
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 723691 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: