Basic Information
| Provider Information | |||||||||
| NPI: | 1649829326 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARCOS | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | ROSALYN DANCEL | ||||||||
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| Credential: | APRN, AGACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2204 FRENCH PL | ||||||||
| Address2: | |||||||||
| City: | BAYTOWN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775203516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322179352 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6720 BERTNER AVE STE O-520 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323552666 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2019 | ||||||||
| LastUpdateDate: | 09/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | AP141805 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.