Provider Demographics
NPI:1053819276
Name:SCALLION, QUNESHA RENEE (FNP)
Entity Type:Individual
Prefix:
First Name:QUNESHA
Middle Name:RENEE
Last Name:SCALLION
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7806 ROLLINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-1707
Mailing Address - Country:US
Mailing Address - Phone:210-202-9666
Mailing Address - Fax:
Practice Address - Street 1:11511 VETERANS MEMORIAL DR STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-2613
Practice Address - Country:US
Practice Address - Phone:281-444-7726
Practice Address - Fax:281-444-9426
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty