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NPI Code Detail

MEDICARE: LA MICHAEL QUINN NEWSOME FNP-C

MEDICARE: LA MICHAEL QUINN NEWSOME FNP-C
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
1163W00000XRegistered Nurse949649TX
2363LF0000XFamily Nurse Practitioner1228485TX

General Provider Information

NPI Number : 1730665415
Entity Type Code : Individual
Provider Name (Legal Business Name) : LA MICHAEL QUINN NEWSOME FNP-C
Provider Business Mailing Address
First Line : 11511 SHADOW CREEK PKWY
Second Line : HR/CREDENTIALING SERVICES
City : PEARLAND
State : TX
Zip : 77584-7298
Country : US
Telephone Number : 713-442-0000
Fax Number :
Provider Business Practice Location Address
First Line : 2727 W HOLCOMBE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77025-1669
Country : US
Telephone Number : 713-442-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2018
Last Update Date : 03/23/2026

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Directions to “ LA MICHAEL QUINN NEWSOME FNP-C” Practice Location

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