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Individual

MARILYN JOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P, ACNP

Contact information

Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(823) 355-2666
Mailing address
6565 FANNIN ST, FONDREN 270, HOUSTON, TX 77030-2703
(713) 441-0006
(713) 790-2727

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
613487
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1790997526
BLUE CROSS BLUE SHIELD
TX
05
219966301
TX
05
219966302
TX
01
P01045652
RR MEDICARE
TX
Enumeration date
10/11/2007
Last updated
12/18/2024
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