Individual provider Active NPI

Christller Quiambao, FNP-C

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1114460706
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
745998 Issued in TX
Practice address
19255 Park Row Ste 201
Houston, TX 77084-7310
Phone
(832) 772-4864
Fax
(832) 321-5098
NPI assigned
Nov 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 745998 TX Primary

Addresses

Primary practice location

19255 Park Row Ste 201
Houston, TX 77084-7310

Mailing address

19255 Park Row
#201
Houston, TX 77084-7309
Phone (832) 772-4864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170308000580 TX Practitioner - Nurse Practitioner 5193009397 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
745998TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Syed a Raza MD PLLC CurrentSince Feb 15, 2017 Accepting new patients

Locations

19255 Park Row
Ste 201
Houston, TX 77084
Phone (281) 369-5262

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": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1114460706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19255 PARK ROW",
            "address_2": "#201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847309",
            "telephone_number": "832-772-4864",
            "fax_number": "832-321-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19255 PARK ROW STE 201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847310",
            "telephone_number": "832-772-4864",
            "fax_number": "832-321-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIAMBAO",
        "first_name": "CHRISTLLER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "745998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.