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NPI Code Detail

MEDICARE: MRS. WENDI LEA PERALTA RN FNP-C

MEDICARE: MRS. WENDI LEA PERALTA RN 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 PractitionerAP120341TX

General Provider Information

NPI Number : 1295020659
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. WENDI LEA PERALTA RN FNP-C
Provider Business Mailing Address
First Line : 301 UNIVERSITY BLVD
Second Line :
City : GALVESTON
State : TX
Zip : 77555-1250
Country : US
Telephone Number : 409-744-4030
Fax Number : 409-740-4187
Provider Business Practice Location Address
First Line : 6710 STEWART RD STE 100
Second Line :
City : GALVESTON
State : TX
Zip : 77551-2216
Country : US
Telephone Number : 409-744-4030
Fax Number : 409-740-4187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2011
Last Update Date : 03/11/2026

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