MEDICARE: BRAZIL ANN CATACUTAN YMBALLA

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	363LA2100X	Acute Care Nurse Practitioner	1227043	TX

General Provider Information

NPI Number	:	1427903061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRAZIL ANN CATACUTAN YMBALLA

Provider Business Mailing Address
First Line	:	2190 NORTH LOOP W STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8016
Country	:	US
Telephone Number	:	281-206-9050
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2703
Country	:	US
Telephone Number	:	346-368-4213
Fax Number	:

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

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	03/07/2026

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