Corey Lynn Proenza

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1191811 Issued in TX

Practice address

2830 Calder St
Beaumont, TX 77702-1809

Phone

(409) 892-7171

NPI assigned

Feb 18, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1295530640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 MARIANNWOOD DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776516015",
            "telephone_number": "409-963-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 CALDER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021809",
            "telephone_number": "409-892-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROENZA",
        "first_name": "COREY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1191811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Occupational Physicians - Texas
• Primevs
• Pristine Practices LLC
• Private Hospital Group LLP
• Jay C. Proctor III, MD
• Pronto Medical Services
• Prosthetic Solution Centers of America, LLC
• Provision Imaging of Beaumont
• Provisionam
• Joseph W Provo III, DDS

• Acute Care Nurse Practitioner in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2025; 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.