Provider Demographics
NPI:1932617933
Name:BRIONES, PAOLO (NP-C)
Entity type:Individual
Prefix:
First Name:PAOLO
Middle Name:
Last Name:BRIONES
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 1:18980 W MEMORIAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4559
Mailing Address - Country:US
Mailing Address - Phone:832-644-8930
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:18980 W MEMORIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4559
Practice Address - Country:US
Practice Address - Phone:832-644-8930
Practice Address - Fax:855-227-3506
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136085363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX437810101Medicaid