Individual
MARY AMANDA THEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8434 RAINTREE WOODS DR, FAIR OAKS RANCH, TX 78015-4437
(318) 376-3819
Mailing address
8434 RAINTREE WOODS DR, FAIR OAKS RANCH, TX 78015-4437
(318) 376-3819
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
879598
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1030889
TX
Other
Enumeration date
10/19/2020
Last updated
05/23/2024
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