MEDICARE: MARY ELLEN OSTROWSKI N.P.

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	363LF0000X	Family Nurse Practitioner	AP117091	TX
2	363L00000X	Nurse Practitioner	638157	TX

General Provider Information

NPI Number	:	1497914709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELLEN OSTROWSKI N.P.

Provider Business Mailing Address
First Line	:	603 S CONROE MEDICAL DR STE 100
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-5395
Country	:	US
Telephone Number	:	936-760-9900
Fax Number	:	936-760-9926

Provider Business Practice Location Address
First Line	:	603 S CONROE MEDICAL DR STE 100
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-5395
Country	:	US
Telephone Number	:	936-760-9900
Fax Number	:	936-760-9926

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

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	08/11/2024

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