Provider Demographics
NPI:1659732345
Name:MZYECE, VICTOR (FNP-C)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:MZYECE
Suffix:
Gender:M
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 1:2600 FM 1764 RD
Mailing Address - Street 2:STE 190
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-2826
Mailing Address - Country:US
Mailing Address - Phone:281-866-8964
Mailing Address - Fax:407-440-8071
Practice Address - Street 1:11226 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3604
Practice Address - Country:US
Practice Address - Phone:281-498-7727
Practice Address - Fax:281-498-5282
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily