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General NPI Number Information
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NPI Number | 1568178226
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Entity Type | Individual
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Provider Name | KEYRA E G VASQUEZ NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 6411 FANNIN ST STE MSB32.44
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-704-4000
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Fax | 713-704-5269
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Provider Business Mailing Address
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Address Line | 206 TRENT ST
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City | VICTORIA
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State | TX
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Zip | 77905-5416
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Country | US
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Telephone | 361-894-1987
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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 | 1057826
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 1057826
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License Number State | TX
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