MEDICARE: MINT PHYSICIAN STAFFING

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	261QP2300X	Primary Care Clinic/Center	F0815232	TX

General Provider Information

NPI Number	:	1598139198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINT PHYSICIAN STAFFING

Provider Business Mailing Address
First Line	:	6335 LYNKAT LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1817
Country	:	US
Telephone Number	:	281-686-8260
Fax Number	:

Provider Business Practice Location Address
First Line	:	6335 LYNKAT LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1817
Country	:	US
Telephone Number	:	281-686-8260
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	MS. SAMIAT O TELUFUSI
Credential	:	RN-BSN,FNP-C
Telephone Number	:	281-686-8260

Provider Enumeration Date	:	11/19/2015
Last Update Date	:	11/19/2015

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Directions to “MINT PHYSICIAN STAFFING ” Practice Location

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