Healthcare Provider Details

I. General information

NPI: 1194782573
Provider Name (Legal Business Name): L. ANNE MAZEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10141 US 59 HWY STE E1
WHARTON TX
77488-7224
US

IV. Provider business mailing address

4911 SANDHILL DR
SUGAR LAND TX
77479-5320
US

V. Phone/Fax

Practice location:
  • Phone: 979-358-9410
  • Fax: 979-358-9411
Mailing address:
  • Phone: 281-238-7870
  • Fax: 281-633-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number524792
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: