MEDICARE: MARITES ANGELO

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	163W00000X	Registered Nurse	896585	TX

General Provider Information

NPI Number	:	1982568622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARITES ANGELO

Provider Business Mailing Address
First Line	:	714 SANTA ELENA TRL
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-3177
Country	:	US
Telephone Number	:	903-336-1883
Fax Number	:

Provider Business Practice Location Address
First Line	:	714 SANTA ELENA TRL
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-3177
Country	:	US
Telephone Number	:	903-336-1883
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ MARITES ANGELO ” Practice Location

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