MEDICARE: MRS. L. ANNE MAZEL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	524792	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	500011692	OTHER	TX	RAILROAD GBA - RAILROAD MEDICARE
5	PO1160255	OTHER	TX	RAILROAD MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	875N31	OTHER	TX	BC/BS #
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194782573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. L. ANNE MAZEL NP

Provider Business Mailing Address
First Line	:	4911 SANDHILL DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-5320
Country	:	US
Telephone Number	:	281-238-7870
Fax Number	:	281-633-4985

Provider Business Practice Location Address
First Line	:	10141 US 59 HWY STE E1
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-7224
Country	:	US
Telephone Number	:	979-358-9410
Fax Number	:	979-358-9411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	07/13/2021

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