Individual
MRS. AMY REYES MICLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, CCRN, APRN-B
Contact information
Practice address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(713) 441-4999
Mailing address
6414 LUSSIER DR, SUGAR LAND, TX 77479-5087
(281) 565-6414
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
513374
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013105733
BLUE CROSS BLUE SHIED
TX
Enumeration date
10/09/2007
Last updated
08/09/2012
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