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General NPI Number Information
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NPI Number | 1720704463
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Entity Type | Individual
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Provider Name | NIRVA ANTOINE JOSEPH-GUILLAUME AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 129 VISION PARK BLVD STE 307
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City | SHENANDOAH
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State | TX
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Zip | 77384-3024
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Country | US
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Telephone | 936-321-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 11511 SHADOW CREEK PKWY
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City | PEARLAND
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State | TX
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Zip | 77584-7298
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Country | US
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Telephone | 713-442-0000
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1041047
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1041047
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License Number State | TX
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