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Individual

TINA MARIE WASIELEWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(713) 798-1000
Mailing address
616 MEMORIAL HEIGHTS DR APT 9311, HOUSTON, TX 77007-6062
(716) 319-4387

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1062350
TX
363LA2200X
Adult Health Nurse Practitioner
1062350
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1062350
APRN-CNP LICENSE
TX
01
42100
PRESCRIPTIVE AUTHORITY
TX
01
886909
RN
TX
Enumeration date
03/11/2022
Last updated
03/24/2026
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