Individual
JEANNE RENEE MATEJKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6200 SAVOY DR STE 150, HOUSTON, TX 77036-3320
(713) 426-1669
(713) 868-9416
Mailing address
PO BOX 926098, HOUSTON, TX 77292-6098
(713) 426-1669
(713) 868-9416
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
435864
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
016138
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109930105
—
TX
01
—
83697U
BCBS INDIVIDUAL PROV #
TX
Enumeration date
05/30/2007
Last updated
06/15/2011
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