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CRISTAL SHAVON NORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(823) 355-2666
Mailing address
6501 FANNIN ST STE NC114, HOUSTON, TX 77030-2703
(713) 798-7356

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP136400
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
382475701
TX
01
382475702
CSHCN TPI
TX
Enumeration date
02/20/2018
Last updated
11/22/2023
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