Basic Information
Provider Information
NPI: 1346581931
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ISTRE
FirstName: TRUDY
MiddleName: B
NamePrefix: MRS.
NameSuffix:  
Credential: RN FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16107 KENSINGTON DR STE 126
Address2:  
City: SUGAR LAND
State: TX
PostalCode: 774794224
CountryCode: US
TelephoneNumber: 2817838162
FaxNumber: 7134397995
Practice Location
Address1: 2610 N. ALEXANDER DR. SUITE 201
Address2:  
City: BAYTOWN
State: TX
PostalCode: 77520
CountryCode: US
TelephoneNumber: 8325566670
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/07/2013
LastUpdateDate: 04/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X605007TXN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XAP123347TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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