Individual
MARIA AVKSHTOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 840853, DALLAS, TX 75284-0865
(972) 715-5000
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
1208
NC
367H00000X
Anesthesiologist Assistant
Primary
1208
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339244101
—
TX
01
—
P01095320
RAILROAD MEDICARE
TX
Enumeration date
09/28/2011
Last updated
09/14/2020
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