Individual
MARLET L CONSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13737 NOEL RD, STE 1400, DALLAS, TX 75240-2004
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
728503
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296828102
—
TX
01
—
8972UD
BCBS
TX
Enumeration date
01/19/2012
Last updated
09/19/2013
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