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General NPI Number Information
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NPI Number | 1316418031
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Entity Type | Individual
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Provider Name | LAURA LETICIA PEREZNEGRON APRN
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Gender | Female
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 22999 HIGHWAY 59 N
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City | KINGWOOD
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State | TX
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Zip | 77339-4412
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Country | US
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Telephone | 281-348-8557
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Fax |
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Provider Business Mailing Address
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Address Line | 15835 MESENBRINK LN
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City | HOUSTON
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State | TX
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Zip | 77049-1179
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Country | US
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Telephone | 281-788-7315
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 823384
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License Number State | TX
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