Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP133818 | TX |
NPI | 1003341660 |
---|---|
Provider Name | Billie Botello |
First Address | Houston, TX 77015-5803 |
Second Address | Houston, TX 77015-5803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2017 |
Last Update Date | 11/05/2017 |