MEDICARE: MARION ANNETTE AWOTONA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1063718070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARION ANNETTE AWOTONA

Provider Business Mailing Address
First Line	:	4935 W OREM DR STE 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4162
Country	:	US
Telephone Number	:	832-343-9480
Fax Number	:

Provider Business Practice Location Address
First Line	:	4935 W OREM DR STE 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4162
Country	:	US
Telephone Number	:	832-343-9480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2011
Last Update Date	:	02/09/2011

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Directions to “ MARION ANNETTE AWOTONA ” Practice Location

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