Healthcare Provider Details

I. General information

NPI: 1447926779
Provider Name (Legal Business Name): KADEL FRADET APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8754 SPRING CYPRESS RD
SPRING TX
77379-3135
US

IV. Provider business mailing address

17595 S TAMIAMI TRL STE 108
FORT MYERS FL
33908-4500
US

V. Phone/Fax

Practice location:
  • Phone: 281-257-4320
  • Fax:
Mailing address:
  • Phone: 239-688-1073
  • Fax: 239-303-4740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1182427
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1182427
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number1182427
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: