MEDICARE: JESSICA SCHNEIDER VANOVER APRN

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	363L00000X	Nurse Practitioner	AP142672	TX

General Provider Information

NPI Number	:	1649804550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SCHNEIDER VANOVER APRN

Provider Business Mailing Address
First Line	:	4800 SUGAR GROVE BLVD STE 603
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-2627
Country	:	US
Telephone Number	:	713-785-7828
Fax Number	:

Provider Business Practice Location Address
First Line	:	4950 FM 1960 RD W STE A6
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4517
Country	:	US
Telephone Number	:	381-444-1711
Fax Number	:

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

Provider Enumeration Date	:	02/29/2020
Last Update Date	:	02/29/2020

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