Individual
MRS. ANN OMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Mailing address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
229012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209303101
—
TX
Enumeration date
07/26/2006
Last updated
04/27/2012
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