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General NPI Number Information
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NPI Number | 1144968413
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Entity Type | Individual
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Provider Name | MARIA LYNN PENTO PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2399
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Country | US
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Telephone | 832-824-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LONGWOOD AVE
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-6000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9261
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19852
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License Number State | TX
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