Individual
MARIA ANGELINA SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(832) 355-2666
(713) 798-4693
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
683835
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP120425
TX
367500000X
Certified Registered Nurse Anesthetist
APRN11021869
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282551501
—
TX
05
—
282551502
—
TX
01
—
8759UB
BLUE CROSS BLUE SHIELD
TX
01
—
P01000988
RAILROAD MEDICARE
TX
Enumeration date
07/15/2011
Last updated
05/15/2025
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