Healthcare Provider Details

I. General information

NPI: 1942329180
Provider Name (Legal Business Name): NATHANAEL SHAY MCGREW APRN, MSN, NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 10/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3307 SPRING STUEBNER RD SUITE A1
SPRING TX
77389-4690
US

IV. Provider business mailing address

3554 HAMILTON BEND LN
SPRING TX
77386-7086
US

V. Phone/Fax

Practice location:
  • Phone: 936-242-9501
  • Fax: 281-719-0027
Mailing address:
  • Phone: 936-242-9501
  • Fax: 281-580-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberSA00005
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP126769
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: