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NPI Code Detail

MEDICARE: SANDRA L RUSSELL FNP

MEDICARE:   SANDRA L RUSSELL  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
1363LA2200XAdult Health Nurse Practitioner513234TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629349303
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA L RUSSELL FNP
Provider Business Mailing Address
First Line : 2150 W. 18TH STREET
Second Line : #300
City : HOUSTON
State : TX
Zip : 77008
Country : US
Telephone Number : 713-426-0027
Fax Number : 713-526-1422
Provider Business Practice Location Address
First Line : 17010 SUGAR PINE DR.
Second Line :
City : HOUSTON
State : TX
Zip : 77090
Country : US
Telephone Number : 281-537-8627
Fax Number : 281-537-8628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2012
Last Update Date : 06/12/2026

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Directions to “ SANDRA L RUSSELL FNP” Practice Location

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