Healthcare Provider Details

I. General information

NPI: 1497945133
Provider Name (Legal Business Name): PHYLLIS ANNETTE MARFO RN, REFLEXOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 BLUE CASTLE CT
HOUSTON TX
77015-1403
US

IV. Provider business mailing address

163 BLUE CASTLE CT
HOUSTON TX
77015-1403
US

V. Phone/Fax

Practice location:
  • Phone: 713-530-4858
  • Fax:
Mailing address:
  • Phone: 713-530-4858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number742110
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: