Provider Demographics
NPI:1699081992
Name:WATERS, JAMES KRISTOPHER (FNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:KRISTOPHER
Last Name:WATERS
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 1:13325 HARGRAVE RD
Mailing Address - Street 2:190
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4539
Mailing Address - Country:US
Mailing Address - Phone:281-807-4301
Mailing Address - Fax:
Practice Address - Street 1:13325 HARGRAVE RD
Practice Address - Street 2:190
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4539
Practice Address - Country:US
Practice Address - Phone:281-807-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX611347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily