Individual
MRS. NIZY ANN SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP130154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358306401
—
TX
01
—
358306402
MEDICAID CSHCN TPI
TX
Enumeration date
03/31/2016
Last updated
09/08/2020
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