Individual
STANLEY MATTHEWS NINAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
684424
TX
363LA2200X
Adult Health Nurse Practitioner
684424
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199861901
—
TX
01
—
8Y9056
BCBS
TX
01
—
P00723851
RR MEDICARE
TX
Enumeration date
10/30/2008
Last updated
03/30/2011
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