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General NPI Number Information
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NPI Number | 1043093917
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Entity Type | Individual
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Provider Name | MIGUEL SUAREZ PORTO FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 7095A HIGHWAY 6 N
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City | HOUSTON
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State | TX
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Zip | 77095-2505
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Country | US
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Telephone | 831-793-7158
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Fax |
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Provider Business Mailing Address
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Address Line | 11819 PINEY BEND DR
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City | TOMBALL
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State | TX
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Zip | 77375-7501
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Country | US
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Telephone | 281-662-3197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1016184
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1016184
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License Number State | TX
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