Provider Demographics
NPI:1649925405
Name:FALCON, DESIREE MARIA (FNP-C)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:MARIA
Last Name:FALCON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:DEISREE
Other - Middle Name:
Other - Last Name:KALLIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:561-570-5172
Mailing Address - Fax:786-472-5770
Practice Address - Street 1:1567 GOLIAD RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-2719
Practice Address - Country:US
Practice Address - Phone:726-202-0998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1058634OtherTEXAS BOARD OF NURSING APRN