Provider Demographics
NPI:1972296408
Name:PONCE, LINDA CRYSTAL (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CRYSTAL
Last Name:PONCE
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:BARRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:831 GLOBE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-1207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6445 MAIN ST STE 2600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1502
Practice Address - Country:US
Practice Address - Phone:713-441-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072310363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine