=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972542124
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIETTE PIERRE M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2006
-----------------------------------------------------
Last Update Date | 02/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1315 ST JOSEPH PKWY SUITE 1503
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77002-8233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-655-0073
-----------------------------------------------------
Fax | 713-655-1332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2450 LOUISIANA ST STE 400 PMB 504
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77006-2318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-655-0073
-----------------------------------------------------
Fax | 713-655-1332
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | L8475
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | L8475
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------