Nurse Practitioner, Pediatrics
AUSTIN CHILDREN'S SHELTER
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1801078241 · enumerated 2007-11-28 · record updated 2007-11-28. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Mr. JERRY FYE, Deputy Director of Finance · (512) 499-0090
Addresses and phones
- Mailing address 804 RIO GRANDE ST STE C, AUSTIN, TX, 78701-2201 (512) 499-0090 Fax (512) 499-0438 Google Maps Apple Maps OpenStreetMap
- Practice location 1501 ENFIELD RD, AUSTIN, TX, 78703 (512) 499-0090 Fax (512) 499-0438 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner, Pediatrics 363LP0200X · Primary · License 596183 TX
In this directory
Locations and evidence
-
Practice location
AUSTIN, TX, 78703
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.