Individual provider Active NPI

Keyra E G Vasquez, NNP-BC

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
National Provider Identifier
1568178226
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
1057826 Issued in TX
Practice address
6411 Fannin St Ste Msb32.44
Houston, TX 77030-1501
Phone
(713) 704-4000
Fax
(713) 704-5269
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1057826 TX
Neonatal-Perinatal Medicine Physician 2080N0001X 1057826 TX Primary

Addresses

Primary practice location

6411 Fannin St Ste Msb32.44
Houston, TX 77030-1501

Mailing address

206 Trent St
Victoria, TX 77905-5416
Phone (361) 894-1987

Other practice location 1

3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone (361) 694-5000 ext. 5335

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1057826TXMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1568178226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 TRENT ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779055416",
            "telephone_number": "361-894-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST STE MSB32.44",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-704-4000",
            "fax_number": "713-704-5269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3533 S Alameda St",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784111721",
            "country_code": "US",
            "telephone_number": "361-694-5000 x5335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "KEYRA",
        "middle_name": "E G",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "1057826",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "1057826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.