Individual
TRACI N WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP128289
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377419201
—
TX
01
—
377419202
MEDICAID CSHCN
TX
Enumeration date
06/08/2009
Last updated
03/17/2018
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