Provider Demographics
NPI:1326372087
Name:FELDER, SHIRL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHIRL
Middle Name:
Last Name:FELDER
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 1:8022 SUMMER NIGHT LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-1692
Mailing Address - Country:US
Mailing Address - Phone:832-493-4178
Mailing Address - Fax:
Practice Address - Street 1:2435 TEXAS PKWY STE K
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4061
Practice Address - Country:US
Practice Address - Phone:281-208-2220
Practice Address - Fax:281-208-2225
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX560714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX310082805Medicaid