Provider Demographics
NPI:1033677539
Name:HODE, ISHTAR (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ISHTAR
Middle Name:
Last Name:HODE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14903 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2603
Mailing Address - Country:US
Mailing Address - Phone:713-363-7640
Mailing Address - Fax:281-333-3509
Practice Address - Street 1:14903 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2603
Practice Address - Country:US
Practice Address - Phone:713-363-7640
Practice Address - Fax:281-333-3509
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1005560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily