MEDICARE: MRS. OSIRIS YAQUELIN PAZ CRUZ NP

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	363LG0600X	Gerontology Nurse Practitioner	AP143049	TX
2	363LF0000X	Family Nurse Practitioner	AP143049	TX

General Provider Information

NPI Number	:	1659921377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. OSIRIS YAQUELIN PAZ CRUZ NP

Provider Business Mailing Address
First Line	:	388 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1303
Country	:	US
Telephone Number	:	346-207-3170
Fax Number	:	877-370-2120

Provider Business Practice Location Address
First Line	:	388 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1303
Country	:	US
Telephone Number	:	346-207-3170
Fax Number	:	877-872-7884

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

Provider Enumeration Date	:	09/14/2019
Last Update Date	:	03/30/2026

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