Provider Demographics
NPI:1154728392
Name:BIJOU, QUINTON GEMYLE (FNP)
Entity type:Individual
Prefix:MR
First Name:QUINTON
Middle Name:GEMYLE
Last Name:BIJOU
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 1:18220 STATE HIGHWAY 249 STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4349
Mailing Address - Country:US
Mailing Address - Phone:281-737-0950
Mailing Address - Fax:281-737-0833
Practice Address - Street 1:18220 STATE HIGHWAY 249 STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4349
Practice Address - Country:US
Practice Address - Phone:281-737-0950
Practice Address - Fax:281-737-0833
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08078363LF0000X
TXAP132162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373179601Medicaid
TX8HA040OtherBCBS
LA2398253Medicaid
TX8HA040OtherBCBS