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General NPI Number Information
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NPI Number | 1467230441
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Entity Type | Organization
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Legal Business Name | MARROD HEALTHCARE PROVIDER, LLC.
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 5330 FRY RD STE C
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City | KATY
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State | TX
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Zip | 77449-6921
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Country | US
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Telephone | 832-810-5060
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Fax | 832-810-5080
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Provider Business Mailing Address
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Address Line | 25914 SUNDROP MEADOWS LN
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City | KATY
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State | TX
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Zip | 77494-3171
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGEL ENRIQUE MARTINEZ PENTON
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Credential | FNP-C
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Telephone | 832-810-5060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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