Provider Demographics
NPI:1205349123
Name:REGISTE, CLAVIS (FNP)
Entity type:Individual
Prefix:
First Name:CLAVIS
Middle Name:
Last Name:REGISTE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 KATY FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1902
Mailing Address - Country:US
Mailing Address - Phone:281-600-5000
Mailing Address - Fax:281-605-6705
Practice Address - Street 1:11511 KATY FWY STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1902
Practice Address - Country:US
Practice Address - Phone:281-600-5000
Practice Address - Fax:281-605-6705
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX741564363L00000X
TXAP134391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner