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General NPI Number Information
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NPI Number | 1285006437
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Entity Type | Individual
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Provider Name | SANDY JOSE NNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2358
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Country | US
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Telephone | 832-733-3332
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Fax | 832-825-6213
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Provider Business Mailing Address
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Address Line | 202 TRILLIUM DR
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City | SUGAR LAND
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State | TX
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Zip | 77479-4416
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Country | US
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Telephone |
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | AP124855
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License Number State | TX
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