Individual
THERESA M. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
AP103697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155840501
—
TX
01
—
890001203
RR MEDICARE
TX
01
—
8N2898
BCBS
TX
Enumeration date
11/01/2006
Last updated
08/06/2024
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