MEDICARE: MARISSETT TOLENTINO NP-C

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	AP145862	TX

General Provider Information

NPI Number	:	1952900425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSETT TOLENTINO NP-C

Provider Business Mailing Address
First Line	:	1977 BUTLER BLVD STE E6.100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4101
Country	:	US
Telephone Number	:	713-798-6673
Fax Number	:

Provider Business Practice Location Address
First Line	:	1977 BUTLER BLVD STE E6.100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4101
Country	:	US
Telephone Number	:	713-798-6673
Fax Number	:

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

Provider Enumeration Date	:	10/25/2020
Last Update Date	:	05/15/2026

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