MEDICARE: MARIGHNEY HANZO

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	1001012	TX

General Provider Information

NPI Number	:	1609672260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIGHNEY HANZO

Provider Business Mailing Address
First Line	:	2500 W WILLIAM CANNON DR STE 601
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 W WILLIAM CANNON DR STE 601
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5320
Country	:	US
Telephone Number	:	512-443-3000
Fax Number	:

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

Provider Enumeration Date	:	02/24/2025
Last Update Date	:	02/24/2025

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Directions to “ MARIGHNEY HANZO ” Practice Location

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