Healthcare Provider Details

I. General information

NPI: 1649867680
Provider Name (Legal Business Name): CAPUCINE BUZZINI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAPUCINE WAGNER

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 ST JOSEPH PKWY
HOUSTON TX
77002-8301
US

IV. Provider business mailing address

7702 PAINTON LN
SPRING TX
77389-3186
US

V. Phone/Fax

Practice location:
  • Phone: 713-757-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number876279
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number1031604
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: