Provider Demographics
NPI:1689754004
Name:NASSER, WENDY QUIROZ (PNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:QUIROZ
Last Name:NASSER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ENRIQUETTE
Other - Last Name:QUIROZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-AC
Mailing Address - Street 1:6701 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2316
Mailing Address - Country:US
Mailing Address - Phone:832-824-6230
Mailing Address - Fax:832-825-6229
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-824-6230
Practice Address - Fax:832-825-6229
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671497363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177517301Medicaid
TX8G2048Medicare PIN
Q58363Medicare UPIN
TX8L6672Medicare PIN