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NPI Code Detail

MEDICARE: LEO ADRIAN CARRASCO FNP-C

MEDICARE: LEO ADRIAN CARRASCO FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1126727TX

General Provider Information

NPI Number : 1023797925
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO ADRIAN CARRASCO FNP-C
Provider Business Mailing Address
First Line : 13711 WALLISVILLE RD STE 1
Second Line :
City : HOUSTON
State : TX
Zip : 77049-3908
Country : US
Telephone Number : 713-455-7777
Fax Number : 713-453-7337
Provider Business Practice Location Address
First Line : 13711 WALLISVILLE RD STE 1
Second Line :
City : HOUSTON
State : TX
Zip : 77049-3908
Country : US
Telephone Number : 713-455-7777
Fax Number : 713-453-7337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 07/17/2023

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Directions to “ LEO ADRIAN CARRASCO FNP-C” Practice Location

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