Individual
MONICA CLAIR BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
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 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP115086
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1662623
—
LA
05
—
191555501
—
TX
05
—
191555502
—
TX
01
—
86472U
BLUE CROSS PROVIDER ID
TX
01
—
P00674688
MEDICARE RAILROAD
TX
Enumeration date
01/18/2007
Last updated
10/17/2019
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