Provider Demographics
NPI:1205824596
Name:PHEIGARU, JONI LYNNE (RN, MSN, PNNP)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:LYNNE
Last Name:PHEIGARU
Suffix:
Gender:F
Credentials:RN, MSN, PNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 GESSNER RD.
Mailing Address - Street 2:SUITE 2225
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2501
Mailing Address - Country:US
Mailing Address - Phone:713-365-2900
Mailing Address - Fax:713-984-6525
Practice Address - Street 1:929 GESSNER RD.
Practice Address - Street 2:SUITE 2225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2501
Practice Address - Country:US
Practice Address - Phone:713-365-2900
Practice Address - Fax:713-984-9525
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX503317363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP20907Medicare UPIN