Provider Demographics
NPI:1902134489
Name:WATERHOUSE, ALERO OBIANYOR (GNP-BC)
Entity Type:Individual
Prefix:
First Name:ALERO
Middle Name:OBIANYOR
Last Name:WATERHOUSE
Suffix:
Gender:F
Credentials:GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 WESTHEIMER RD STE 1-559
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5271
Mailing Address - Country:US
Mailing Address - Phone:713-955-7374
Mailing Address - Fax:702-537-0985
Practice Address - Street 1:3733 WESTHEIMER RD STE 1-559
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027
Practice Address - Country:US
Practice Address - Phone:713-955-7374
Practice Address - Fax:702-537-0985
Is Sole Proprietor?:No
Enumeration Date:2009-11-22
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX716564163W00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
8L23628Medicare PIN
TXTXB105562Medicare PIN
8L23111Medicare PIN