Concepcion Fanous is one of 637 nurse practitioners practicing in Tyler, Texas .
Concepcion Fanous practices with Charles R Gordon MD PA.
Registry record (NPPES)
NPI
1366150260
Type
Type 1 · Individual
Primary taxonomy
Nurse Practitioner, Family · 363LF0000X
Address on file
2737 S Broadway Ave
Enumerated
Nov 9, 2022
Record last updated
Apr 15, 2026
License states listed
TX
Medicare (CMS)
Enrollment
Medicare-enrolled in TXNurse Practitioner
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
2737 S Broadway AveTyler , TX 75701
More nurse practitioners in Tyler
Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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