Individual
ELIZABETH DANIELLE DEWALCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP118782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212099001
—
TX
01
—
8146UA
BLUE CROSS BLUE SHIELD
TX
01
—
P00832002
RR MEDICARE
TX
Enumeration date
08/26/2009
Last updated
02/23/2017
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