Provider Demographics
NPI:1205603222
Name:FIGUEROA, JORGE (APRN)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N GREATWOOD GLEN PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-1591
Mailing Address - Country:US
Mailing Address - Phone:760-718-9443
Mailing Address - Fax:
Practice Address - Street 1:107 N GREATWOOD GLEN PL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-1591
Practice Address - Country:US
Practice Address - Phone:760-718-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1142646363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health