Healthcare Provider Details

I. General information

NPI: 1104757483
Provider Name (Legal Business Name): PEYTON ELISE PAUZE FISHBACK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PEYTON PAUZE FNP-C

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24285 KATY FWY STE 300
KATY TX
77494-1128
US

IV. Provider business mailing address

22523 VISTA VALLEY DR
KATY TX
77450-4422
US

V. Phone/Fax

Practice location:
  • Phone: 346-387-7171
  • Fax:
Mailing address:
  • Phone: 713-569-0199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1093883
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: