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General NPI Number Information
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NPI Number | 1245103753
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Entity Type | Individual
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Provider Name | MARIEL MACHUCA KOH ACNP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 3080 COLLEGE ST
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City | BEAUMONT
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State | TX
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Zip | 77701-4606
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Country | US
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Telephone | 409-212-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 615 JACKSON HILL ST
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City | HOUSTON
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State | TX
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Zip | 77007-5770
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Country | US
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Telephone | 281-381-8266
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1195178
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License Number State | TX
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