MEDICARE: GERALDINE TAER CAMPOS NURSE PRACTITIONER

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	363LP2300X	Primary Care Nurse Practitioner	1029214	TX

General Provider Information

NPI Number	:	1528634649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALDINE TAER CAMPOS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	7915 FM 1960 RD W STE 122
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5716
Country	:	US
Telephone Number	:	678-739-1879
Fax Number	:

Provider Business Practice Location Address
First Line	:	7915 FM 1960 RD W STE 122
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5716
Country	:	US
Telephone Number	:	832-245-4816
Fax Number	:

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

Provider Enumeration Date	:	05/30/2021
Last Update Date	:	05/30/2021

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Directions to “ GERALDINE TAER CAMPOS NURSE PRACTITIONER” Practice Location

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