Active NPI
Carolina Deandres, NP
- Family Nurse Practitioner
- Conroe, TX
National Provider Identifier
1033510888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP126029
- Practice address
- 503 Medical Center Blvd Ste 100
Conroe, TX 77304-2928 - Phone
- (936) 788-1030
- Fax
- (936) 788-2844
- NPI assigned
- Sep 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP126029 | TX | Primary |
Addresses
Primary practice location
503 Medical Center Blvd Ste 100
Conroe, TX 77304-2928
Mailing address
503 Medical Center Blvd Ste 100
Conroe, TX 77304-2928
Phone (936) 788-1030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP126029 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut Physicians | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463356800000",
"number": "1033510888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 MEDICAL CENTER BLVD STE 100",
"city": "CONROE",
"state": "TX",
"postal_code": "773042928",
"telephone_number": "936-788-1030",
"fax_number": "936-788-2844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 MEDICAL CENTER BLVD STE 100",
"city": "CONROE",
"state": "TX",
"postal_code": "773042928",
"telephone_number": "936-788-1030",
"fax_number": "936-788-2844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANDRES",
"first_name": "CAROLINA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-11",
"last_updated": "2016-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP126029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.