Provider Demographics
NPI:1811191240
Name:BELL-GORDON, CHARYL RENEE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHARYL
Middle Name:RENEE
Last Name:BELL-GORDON
Suffix:
Gender:F
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 1:2604 SPARKLING BROOK CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1657
Mailing Address - Country:US
Mailing Address - Phone:713-436-7183
Mailing Address - Fax:
Practice Address - Street 1:6565 FANNIN
Practice Address - Street 2:MGJ 11-002
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-441-4515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily