Provider Demographics
NPI:1366534521
Name:ARRIAGA, THERESA RENEE (FNP)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:RENEE
Last Name:ARRIAGA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8807 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-5023
Mailing Address - Country:US
Mailing Address - Phone:281-914-3005
Mailing Address - Fax:
Practice Address - Street 1:207A THAT WAY ST
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5211
Practice Address - Country:US
Practice Address - Phone:979-297-8800
Practice Address - Fax:979-297-0300
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX554371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily