Individual
YLAIZZA MICAH DIEZ CANIZARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 GARTH RD, BAYTOWN, TX 77521-2122
(281) 420-8600
Mailing address
5607 CARAWAY LAKE DR, BAYTOWN, TX 77521-7525
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1136059
TX
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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