Holly Bronson Black, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Fulshear, TX
NPI 1194941450 · NPPES record last updated Mar 30, 2022
Key facts
- NPI
- 1194941450
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 628292 (TX)
- Practice address
- 7629 Tiki Dr
Fulshear, TX 77441-1548 - Phone
- (281) 398-7353
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 628292 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiology Center of Houston PA | Current |
Accepting new patients | |
| Heidi Schultz, M.D., P.a. | Current |
Accepting new patients | |
| TCH Pediatric Associates, Inc | Past | Accepting new patients | |
| TCH Pediatric Associates, Inc | Past | Accepting new patients |
Locations
600 Jefferson St
Ste 404
Lafayette, LA 70501
7629 Tiki Dr
Fulshear, TX 77441
Phone (281) 346-0018
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CEDECA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 628292 | TX | Yes |
Addresses
Primary practice location
7629 Tiki Dr
Fulshear, TX 77441-1548
Mailing address
600 Jefferson St Ste 404
Lafayette, LA 70501-6991
Phone (281) 346-0018
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | holly.black@fulm.eclinicaldirectplus.com | Direct |
Other providers in Fulshear, TX
- Beth-Elias Enterprises LLC
- Prativa N Bhandari
- Hasib H Bhojwani
- Big Blue Surgical Assisting
- Bill Techno LLC
- Blitheness Healthcare LLC
- Boom Transportation Services LLC
- Berrilyn Boydston
- Yolimar Navas Bravo
- Mia K Breaux
All providers in Fulshear, TX · Pediatric Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.