Healthcare Provider Details

I. General information

NPI: 1851999817
Provider Name (Legal Business Name): JOHN MANUEL LINARES NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13630 BEAMER RD STE 109
HOUSTON TX
77089-6038
US

IV. Provider business mailing address

11400 SPACE CENTER BLVD APT 8105
HOUSTON TX
77059-3637
US

V. Phone/Fax

Practice location:
  • Phone: 713-382-0008
  • Fax: 541-240-2160
Mailing address:
  • Phone: 713-382-0008
  • Fax: 541-240-2160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1016216
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: