Individual
MALLORY FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
6701 FANNIN ST, HOUSTON, TX 77030-2608
(832) 824-1000
Mailing address
2 GREENWAY PLZ, SUITE 300, HOUSTON, TX 77046-0297
(832) 828-3660
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
848372
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
848372
LICENSE
TX
Enumeration date
02/05/2014
Last updated
04/20/2015
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