Provider Demographics
NPI:1124064100
Name:DANIEL, MARY JOY (NP)
Entity type:Individual
Prefix:
First Name:MARY JOY
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARY JOY
Other - Middle Name:TALIGATOS
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1661 A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-6382
Mailing Address - Fax:713-790-2992
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1661 A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-6382
Practice Address - Fax:713-790-2992
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP114304363LA2100X
TX635522363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8954NDOtherBLUE CROSS BLUE SHIELD
TX184825102Medicaid
TX184825102Medicaid