Individual
MADELINE J RETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1635 NORTH LOOP WEST, HOUSTON, TX 77008-1593
(713) 400-2990
(713) 400-2993
Mailing address
POST OFFICE BOX 22926, JACKSON, MS 39225-2926
(713) 400-2990
(713) 400-2993
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN770598
TX
363L00000X
Nurse Practitioner
CRNA102349
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
770598
TX
367500000X
Certified Registered Nurse Anesthetist
AP125812
TX
Other
Enumeration date
06/11/2014
Last updated
10/03/2018
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