Individual provider Active NPI

Nicole Couvillon Fawcett, AGNP-C

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1649772716
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP136808 Issued in TX
Practice address
3100 Weslayan St Ste 350
Houston, TX 77027-5733
Phone
(713) 533-1700
Fax
(713) 533-1708
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP136808 TX
Gerontology Nurse Practitioner 363LG0600X AP136808 TX Primary

Addresses

Primary practice location

3100 Weslayan St Ste 350
Houston, TX 77027-5733

Mailing address

PO Box 873
Bellaire, TX 77402-0873
Phone (713) 533-1700

Other practice location 1

5020 Kelvin Dr
Houston, TX 77005-2533
Phone (281) 886-8082

Other practice location 2

901 W Baker Rd
Baytown, TX 77521-2398
Phone (866) 659-2295

Other practice location 3

331 Fall Creek Dr
Huffman, TX 77336-2887
Phone (281) 235-2974

Other practice location 4

504 Bering Dr
Houston, TX 77057-1479
Phone (832) 699-1767

Other practice location 5

5000 Cypresswood Dr
Spring, TX 77379-1500
Phone (832) 639-8540

Other practice location 6

20305 Holzwarth Rd
Spring, TX 77388-5582
Phone (281) 257-2299

Other practice location 7

1407 Studewood St
Houston, TX 77008-4588
Phone (713) 802-9700

Other practice location 8

4141 N Braeswood Blvd
Houston, TX 77025-2900
Phone (713) 665-4141

Other practice location 9

1015 S Shepherd Dr
Houston, TX 77019-1122
Phone (713) 952-7600

Other practice location 10

4620 Bellaire Blvd
Bellaire, TX 77401-4231
Phone (713) 665-3888

Other practice location 11

14100 Karissa Ct
Houston, TX 77049-3866
Phone (713) 340-5200

Other practice location 12

4048 Red Bluff Rd
Pasadena, TX 77503-3606
Phone (713) 477-7877

Other identifiers 5

IdentifierTypeStateIssuer
385955503MedicaidTX
385955502MedicaidTX
8KS668OtherTXBCBS TX RECORD ID
385955504MedicaidTX
385955501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190228000327 TX Practitioner - Nurse Practitioner 8325387830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael E Buxbaum DO PAGroup PAC ID 6305918103, 4 clinicians

Practice addresses (Care Compare)

1015 S Shepherd Dr
Houston, TX 77019-1122
Phone (713) 952-7600

3100 Weslayan St
Suite 350
Houston, TX 77027-5733
Phone (713) 533-1700

4141 N Braeswood Blvd
Houston, TX 77025-2900
Phone (713) 665-4141

4620 Bellaire Blvd
Bellaire, TX 77401-4231
Phone (713) 665-3888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael E. Buxbaum, D.O. P.a. Gerontology CurrentSince Apr 1, 2019 Accepting new patients
Ivan C Spector MD PA PastSince Apr 21, 2024 Accepting new patients

Locations

1213 Hermann Dr
Ste 230
Houston, TX 77004
Phone (713) 533-0900

14100 Karissa Ct
Houston, TX 77049
Phone (713) 340-5200

6699 Chimney Rock Rd
Ste 201
Houston, TX 77081
Phone (713) 533-1700

3100 Weslayan St
Ste 350
Houston, TX 77027
Phone (713) 533-1700

4048 Red Bluff Rd
Pasadena, TX 77503
Phone (713) 477-7877

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1649772716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 873",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774020873",
            "telephone_number": "713-533-1700",
            "fax_number": "713-533-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 WESLAYAN ST STE 350",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770275733",
            "telephone_number": "713-533-1700",
            "fax_number": "713-533-1708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5020 Kelvin Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770052533",
            "country_code": "US",
            "telephone_number": "281-886-8082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 W Baker Rd",
            "address_purpose": "LOCATION",
            "city": "Baytown",
            "state": "TX",
            "postal_code": "775212398",
            "country_code": "US",
            "telephone_number": "866-659-2295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "331 Fall Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Huffman",
            "state": "TX",
            "postal_code": "773362887",
            "country_code": "US",
            "telephone_number": "281-235-2974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 Bering Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770571479",
            "country_code": "US",
            "telephone_number": "832-699-1767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Cypresswood Dr",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773791500",
            "country_code": "US",
            "telephone_number": "832-639-8540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20305 Holzwarth Rd",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773885582",
            "country_code": "US",
            "telephone_number": "281-257-2299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1407 Studewood St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770084588",
            "country_code": "US",
            "telephone_number": "713-802-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4141 N Braeswood Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770252900",
            "country_code": "US",
            "telephone_number": "713-665-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 S Shepherd Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770191122",
            "country_code": "US",
            "telephone_number": "713-952-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4620 Bellaire Blvd",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774014231",
            "country_code": "US",
            "telephone_number": "713-665-3888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14100 Karissa Ct",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770493866",
            "country_code": "US",
            "telephone_number": "713-340-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4048 Red Bluff Rd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775033606",
            "country_code": "US",
            "telephone_number": "713-477-7877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUVILLON FAWCETT",
        "first_name": "NICOLE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP136808",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP136808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385955503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385955502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX RECORD ID",
            "identifier": "8KS668",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385955504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385955501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.