Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | R5949 | TX |
NPI | 1013303551 |
---|---|
Provider Name | Dr. Mariatu Verla |
First Address | Houston, TX 77030-3411 |
Second Address | Houston, TX 77030-3411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2015 |
Last Update Date | 14/02/2018 |