Healthcare Provider Details

I. General information

NPI: 1992389985
Provider Name (Legal Business Name): DIEDRA LYN TROUTMAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E MEDICAL CENTER BLVD STE D
WEBSTER TX
77598-4373
US

IV. Provider business mailing address

2801 SCARLET OAK CT
FRIENDSWOOD TX
77546-5195
US

V. Phone/Fax

Practice location:
  • Phone: 281-990-9979
  • Fax: 281-990-9916
Mailing address:
  • Phone: 806-640-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1037451
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number762767
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: