MEDICARE: MISS SONDRA A MARKLE GNP

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	363LG0600X	Gerontology Nurse Practitioner	628157	TX

General Provider Information

NPI Number	:	1972824761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SONDRA A MARKLE GNP

Provider Business Mailing Address
First Line	:	650 N SAM HOUSTON PKWY E STE 105B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-5918
Country	:	US
Telephone Number	:	281-272-1743
Fax Number	:	281-272-1758

Provider Business Practice Location Address
First Line	:	650 N SAM HOUSTON PKWY E STE 105B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-5918
Country	:	US
Telephone Number	:	281-272-1743
Fax Number	:	281-272-1758

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

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	07/21/2022

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