MEDICARE: NEREIDA MARIA MANUEL ARNP

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	363LF0000X	Family Nurse Practitioner	AP134733	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1760772560	OTHER		1760772560

General Provider Information

NPI Number	:	1760772560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEREIDA MARIA MANUEL ARNP

Provider Business Mailing Address
First Line	:	5201 HARRISBURG BLVD STE C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4229
Country	:	US
Telephone Number	:	832-275-2696
Fax Number	:	832-834-6075

Provider Business Practice Location Address
First Line	:	5201 HARRISBURG BLVD STE C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4229
Country	:	US
Telephone Number	:	832-275-2696
Fax Number	:	832-834-6075

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

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	03/15/2019

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