Individual provider Active NPI

Lisa R. Brazil, L.V.N.

  • Licensed Vocational Nurse
  • Houston, TX
National Provider Identifier
1053473124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
07605 Issued in TX
Practice address
4211 Valedon LN
Houston, TX 77014-1839
Phone
(210) 334-9575
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 07605 TX Primary

Addresses

Primary practice location

4211 Valedon LN
Houston, TX 77014-1839

Mailing address

911 S Hackberry
San Antonio, TX 78210-1929
Phone (210) 532-4727

Other identifiers 1

IdentifierTypeStateIssuer
001002645OtherTXPROVIDER

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
07605TXMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053473124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 S HACKBERRY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782101929",
            "telephone_number": "210-532-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VALEDON LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770141839",
            "telephone_number": "210-334-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZIL",
        "first_name": "LISA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "L.V.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "07605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "001002645",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.