Healthcare Provider Details

I. General information

NPI: 1780098350
Provider Name (Legal Business Name): AMY SELKE MCCAY N.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 GESSNER RD
HOUSTON TX
77024-2501
US

IV. Provider business mailing address

10114 OLYMPIA DR
HOUSTON TX
77042-2930
US

V. Phone/Fax

Practice location:
  • Phone: 713-242-3650
  • Fax:
Mailing address:
  • Phone: 713-201-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP109632
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: