MEDICARE: MIGUEL SUAREZ PORTO 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
1	363LF0000X	Family Nurse Practitioner	1016184	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1016184	TX
3	363L00000X	Nurse Practitioner	1016184	TX

General Provider Information

NPI Number	:	1043093917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL SUAREZ PORTO FNP-C

Provider Business Mailing Address
First Line	:	11819 PINEY BEND DR
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-7501
Country	:	US
Telephone Number	:	281-662-3197
Fax Number	:

Provider Business Practice Location Address
First Line	:	13145 SPRING CYPRESS RD
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-2004
Country	:	US
Telephone Number	:	281-724-7980
Fax Number	:	281-746-6268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	05/11/2026

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