Individual
EVANGELINE T. MASALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
505246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178012401
—
TX
01
—
8N9616
BCBS
TX
01
—
P00881565
RR MEDICARE
TX
Enumeration date
10/17/2006
Last updated
08/20/2011
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