Provider Demographics
NPI:1588402242
Name:FOUNDATIONS MEDICAL CARE PLLC
Entity type:Organization
Organization Name:FOUNDATIONS MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:FELISA
Authorized Official - Middle Name:DIANA
Authorized Official - Last Name:LESSER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-975-7579
Mailing Address - Street 1:2401 BISBEE RD
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7191
Mailing Address - Country:US
Mailing Address - Phone:832-975-7579
Mailing Address - Fax:832-281-0975
Practice Address - Street 1:612 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3768
Practice Address - Country:US
Practice Address - Phone:832-975-7579
Practice Address - Fax:832-281-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty