Provider Demographics
NPI:1780305235
Name:MANON, MARCOS ANTONIO II (REGISTERED NURSE)
Entity type:Individual
Prefix:MR
First Name:MARCOS
Middle Name:ANTONIO
Last Name:MANON
Suffix:II
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 BELLGROVE DR
Mailing Address - Street 2:
Mailing Address - City:EL LAGO
Mailing Address - State:TX
Mailing Address - Zip Code:77586-6028
Mailing Address - Country:US
Mailing Address - Phone:281-468-8932
Mailing Address - Fax:
Practice Address - Street 1:6720 BERTNER AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2604
Practice Address - Country:US
Practice Address - Phone:832-355-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN634498163W00000X
TX817876163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse