Provider Demographics
NPI:1669151569
Name:CARRASCO, ANAIS (FNP-C)
Entity type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:CARRASCO
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 1:13711 WALLISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-3908
Mailing Address - Country:US
Mailing Address - Phone:713-455-7777
Mailing Address - Fax:713-453-7337
Practice Address - Street 1:13711 WALLISVILLE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-3908
Practice Address - Country:US
Practice Address - Phone:713-455-7777
Practice Address - Fax:713-453-7337
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126721363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily