Provider Demographics
NPI:1912876285
Name:ENRIQUEZ AVILES, MAYDELIN (FNP)
Entity type:Individual
Prefix:
First Name:MAYDELIN
Middle Name:
Last Name:ENRIQUEZ AVILES
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 1:8214 CADDO RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77078-2216
Mailing Address - Country:US
Mailing Address - Phone:346-441-1681
Mailing Address - Fax:
Practice Address - Street 1:8214 CADDO RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77078-2216
Practice Address - Country:US
Practice Address - Phone:346-441-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11043233363LF0000X
TX1049375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily