Basic Information
Provider Information | |||||||||
NPI: | 1952059958 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FIRES | ||||||||
FirstName: | ESTHER | ||||||||
MiddleName: | FAITH | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | PMHNP-BC | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | HOUSER | ||||||||
OtherFirstName: | ESTHER | ||||||||
OtherMiddleName: | FAITH | ||||||||
OtherNamePrefix: | MISS | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | RN | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 5524 BEE CAVES RD STE K4 | ||||||||
Address2: |   | ||||||||
City: | WEST LAKE HILLS | ||||||||
State: | TX | ||||||||
PostalCode: | 787465247 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5127100551 | ||||||||
FaxNumber: | 5127176337 | ||||||||
Practice Location | |||||||||
Address1: | 14101 W HWY 290 STE 100 | ||||||||
Address2: |   | ||||||||
City: | AUSTIN | ||||||||
State: | TX | ||||||||
PostalCode: | 787379332 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5127100551 | ||||||||
FaxNumber: | 5127176337 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/17/2022 | ||||||||
LastUpdateDate: | 09/02/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 09/02/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | APRN11018588 | FL | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.