Provider Demographics
NPI:1487303616
Name:EMESIH, LORETTA O
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:O
Last Name:EMESIH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23307 FIELDROSE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2879
Mailing Address - Country:US
Mailing Address - Phone:832-235-0771
Mailing Address - Fax:
Practice Address - Street 1:23307 FIELDROSE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2879
Practice Address - Country:US
Practice Address - Phone:832-235-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily