Jacqueline Watson, ANP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

671036 Issued in TX

Practice address

4102 Fannin St
Houston, TX 77004-4808

Phone

(713) 524-2633

Fax

(713) 524-2639

NPI assigned

Jul 24, 2010

Last updated

Jul 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Marys Medi Spa LLC

  dba St Marys Medi Spa

  • Clinic/Center
  • Houston, TX
  • NPI 1841860327
  NPD Authorized official

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

{
    "created_epoch": "1279929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1467765081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770044808",
            "telephone_number": "713-524-2633",
            "fax_number": "713-524-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770044808",
            "telephone_number": "713-524-2633",
            "fax_number": "713-524-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JACQUELINE",
        "credential": "ANP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-24",
        "last_updated": "2021-07-26",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "671036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Charles Watson, CRNA
• Gwendolyn M Watson, DDS
• Heather Lynn Watson, LPC
• Isabel Della Watson
• Jacob Basil Watson, MD
• Janeka M Watson, MSW
• Jerinda Watson
• Julia Watson, PT, DPT
• Kanteria Ronique Watson
• Kayla Watson, D.C.

• Adult Health Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.