Individual provider Active NPI

Javier Fragoso Fleitas, RN

  • Registered Nurse
  • Odessa, TX
National Provider Identifier
1467325837
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1189974 Issued in TX
Practice address
8640 Hunter Miller Way Apt 1217
Odessa, TX 79765-8761
Phone
(305) 339-1721
NPI assigned
Sep 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 1189974 TX
Ambulatory Care Registered Nurse 163WP2201X 1189974 TX
Infusion Therapy Registered Nurse 163WI0500X 1189974 TX
Nutrition Support Registered Nurse 163WN1003X 1189974 TX
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 1189974 TX Primary
Continuing Education/Staff Development Registered Nurse 163WC1600X 1189974 TX

Addresses

Primary practice location

8640 Hunter Miller Way Apt 1217
Odessa, TX 79765-8761

Mailing address

8640 Hunter Miller Way Apt 1217
Odessa, TX 79765-8761
Phone (305) 339-1721

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1189974TXMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1467325837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 HUNTER MILLER WAY APT 1217",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658761",
            "telephone_number": "305-339-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 HUNTER MILLER WAY APT 1217",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658761",
            "telephone_number": "305-339-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGOSO FLEITAS",
        "first_name": "JAVIER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "1189974",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TX",
            "license": "1189974",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "TX",
            "license": "1189974",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "TX",
            "license": "1189974",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1189974",
            "primary": true
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "TX",
            "license": "1189974",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.