Individual
MRS. BRISTEN THEVENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 W 38TH ST, AUSTIN, TX 78705-1006
(512) 324-1000
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
205061
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
1217655
TX
367500000X
Certified Registered Nurse Anesthetist
205061
LA
Other
Enumeration date
07/22/2024
Last updated
03/05/2026
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