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General NPI Number Information
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NPI Number | 1730057415
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Entity Type | Individual
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Provider Name | LIOVANNIS GUZMAN LEGRA NP
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Gender | Male
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Dates
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Enumeration Date | 10/25/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1313 HOLLAND ST STE C
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City | HOUSTON
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State | TX
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Zip | 77029-2873
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Country | US
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Telephone | 281-888-3128
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Fax | 972-584-6141
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Provider Business Mailing Address
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Address Line | 553 ROAD 5822
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City | CLEVELAND
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State | TX
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Zip | 77327-6166
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Country | US
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Telephone | 713-514-7249
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Fax | 972-584-6141
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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 | 1100126
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License Number State | TX
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