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NPI Code Detail

MEDICARE: CARMEN ELISA VEGA APRN, FNP-BC

MEDICARE: CARMEN ELISA VEGA APRN, FNP-BC
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
1207Q00000XFamily Medicine PhysicianAP134072TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11063917896OTHERTXPANAMERICANA FAMILY MEDICINE CLINIC

General Provider Information

NPI Number : 1689102782
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN ELISA VEGA APRN, FNP-BC
Provider Business Mailing Address
First Line : 1900 BLALOCK RD
Second Line : STE M
City : HOUSTON
State : TX
Zip : 77080-5446
Country : US
Telephone Number : 713-240-1221
Fax Number :
Provider Business Practice Location Address
First Line : 1900 BLALOCK RD
Second Line : STE M
City : HOUSTON
State : TX
Zip : 77080-5446
Country : US
Telephone Number : 281-589-8500
Fax Number : 281-589-7165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2017
Last Update Date : 07/16/2019

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