Provider Demographics
NPI:1720791056
Name:TEXAS NURSE ADVOCATE PLLC
Entity type:Organization
Organization Name:TEXAS NURSE ADVOCATE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MOURRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-601-9034
Mailing Address - Street 1:23910 W INTERSTATE 10 APT 4209
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1387
Mailing Address - Country:US
Mailing Address - Phone:210-601-9034
Mailing Address - Fax:
Practice Address - Street 1:17 OLD SAN ANTONIO RD STE 202
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3495
Practice Address - Country:US
Practice Address - Phone:830-331-9880
Practice Address - Fax:210-519-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty