MEDICARE: NICOLE MISURACA

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	363LP0200X	Pediatric Nurse Practitioner	1216598	TX

General Provider Information

NPI Number	:	1114884731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MISURACA

Provider Business Mailing Address
First Line	:	23467 MILLBROOK DR
Second Line	:
City	:	NEW CANEY
State	:	TX
Zip	:	77357-1550
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12337 JONES RD STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4951
Country	:	US
Telephone Number	:	281-984-9480
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	04/21/2026

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Directions to “ NICOLE MISURACA ” Practice Location

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