Provider Demographics
NPI:1699168799
Name:JAVALUYAS, EMMANUEL (NP-C)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:JAVALUYAS
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11314 MISTY MORNING ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8268
Mailing Address - Country:US
Mailing Address - Phone:713-441-1762
Mailing Address - Fax:
Practice Address - Street 1:8800 LONG POINT RD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3015
Practice Address - Country:US
Practice Address - Phone:713-973-8292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAPN123588363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health