Healthcare Provider Details

I. General information

NPI: 1922626225
Provider Name (Legal Business Name): AUDREY PIKA APRN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 FARM TO MARKET 2920 STE B6
SPRING TX
77354
US

IV. Provider business mailing address

3625 FARM TO MARKET 2920 STE B6
SPRING TX
77388
US

V. Phone/Fax

Practice location:
  • Phone: 281-370-7272
  • Fax:
Mailing address:
  • Phone: 281-370-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1066944
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: