Provider Demographics
NPI:1265904866
Name:ROSALES, LIZANDRA (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:LIZANDRA
Middle Name:
Last Name:ROSALES
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12779 JONES RD STE 109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4687
Mailing Address - Country:US
Mailing Address - Phone:346-206-3963
Mailing Address - Fax:346-206-3983
Practice Address - Street 1:12779 JONES RD STE 109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4687
Practice Address - Country:US
Practice Address - Phone:346-206-3963
Practice Address - Fax:346-206-3983
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140040363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily