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General NPI Number Information
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NPI Number | 1639785355
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Entity Type | Individual
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Provider Name | ANGEL RAMON SANTOS MAZQUIARAN FNP
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Gender | Male
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 02/06/2021
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Provider Practice Location Address
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Address Line | 10656 JONES RD
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City | HOUSTON
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State | TX
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Zip | 77065-4214
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Country | US
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Telephone | 281-970-6966
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Fax | 281-970-6983
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Provider Business Mailing Address
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Address Line | 3010 FORT STOCKTON DR
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City | KATY
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State | TX
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Zip | 77449-6255
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Country | US
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Telephone | 832-858-4407
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1028775
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License Number State | TX
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