MEDICARE: ANTHONY PATRICK NERY MAMARIL

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	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1366381428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY PATRICK NERY MAMARIL

Provider Business Mailing Address
First Line	:	6550 FANNIN ST
Second Line	:	SM383
City	:	HOUSTON
State	:	TX
Zip	:	77030-2717
Country	:	US
Telephone Number	:	713-793-1183
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2717
Country	:	US
Telephone Number	:	713-793-1183
Fax Number	:

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

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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