Individual
ANECITA P. FADOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP, CNS
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(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
AP104116
TX
363LF0000X
Family Nurse Practitioner
444828
TX
364S00000X
Clinical Nurse Specialist
444828
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41812102
—
TX
01
—
8N3143
BCBS
TX
01
—
Q00088921
RR MEDICARE
TX
Enumeration date
10/11/2006
Last updated
06/22/2021
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