MEDICARE: ASTRID MARCELA QUIROGA RN, FNP

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	725714	TX

General Provider Information

NPI Number	:	1447583646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASTRID MARCELA QUIROGA RN, FNP

Provider Business Mailing Address
First Line	:	723 SHOTWELL ST
Second Line	:	SUITE B
City	:	HOUSTON
State	:	TX
Zip	:	77020-4813
Country	:	US
Telephone Number	:	713-673-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	723 SHOTWELL ST
Second Line	:	SUITE B
City	:	HOUSTON
State	:	TX
Zip	:	77020-4813
Country	:	US
Telephone Number	:	713-673-9400
Fax Number	:	713-673-9401

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

Provider Enumeration Date	:	09/07/2009
Last Update Date	:	03/19/2012

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