Provider Demographics
NPI:1689803496
Name:WATSON, LOY ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LOY
Middle Name:ELIZABETH
Last Name:WATSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:LOY
Other - Middle Name:ELIZABETH
Other - Last Name:MCEACHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1500 UNIVERSITY DR E STE 100
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-2600
Mailing Address - Country:US
Mailing Address - Phone:979-383-2340
Mailing Address - Fax:979-260-9390
Practice Address - Street 1:1103 WOODSON DR
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:TX
Practice Address - Zip Code:77836-1052
Practice Address - Country:US
Practice Address - Phone:979-567-7080
Practice Address - Fax:979-567-9783
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000169929163WC1500X
TXAP144094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health