Healthcare Provider Details

I. General information

NPI: 1063095149
Provider Name (Legal Business Name): MAWENA ASSETS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 SHAVER ST STE 125
PASADENA TX
77504-2755
US

IV. Provider business mailing address

10707 SILKWOOD DR
HOUSTON TX
77031-1110
US

V. Phone/Fax

Practice location:
  • Phone: 346-461-2828
  • Fax:
Mailing address:
  • Phone: 346-461-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: IMAYARZE LIMONTA-CORDERO
Title or Position: OWNER
Credential: FNP-C, CWS, PMHNP
Phone: 346-461-2828