Provider Demographics
NPI:1114506979
Name:SROUR, CELESTE ALEXIS (FNP-C)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:ALEXIS
Last Name:SROUR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 MEADOW PASS LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-2324
Mailing Address - Country:US
Mailing Address - Phone:832-370-6157
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR # 15855
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:737-727-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF06210030363LF0000X
TX1046844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily