Provider Demographics
NPI:1487045605
Name:BAUTISTA, YANIRA (NP)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:BAUTISTA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:YANIRA
Other - Middle Name:
Other - Last Name:BAUTISTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:4000 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-4766
Mailing Address - Country:US
Mailing Address - Phone:713-931-4040
Mailing Address - Fax:713-884-8989
Practice Address - Street 1:4000 FULTON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-4766
Practice Address - Country:US
Practice Address - Phone:713-931-4040
Practice Address - Fax:713-884-8989
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily