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Individual

MRS. MARY T ALTORFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1500 CITYWEST BLVD STE 300, HOUSTON, TX 77042
(713) 620-4000
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209008959
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
AP121881
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
306341402
TX
01
8347UK
BCBS
TX
01
P01532070
RR MEDICARE
TX
Enumeration date
08/12/2011
Last updated
06/05/2018
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