Individual
MONA E IVERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 SUNSET BLVD, HOUSTON, TX 77005-1713
(713) 526-5511
(713) 520-4755
Mailing address
1701 SUNSET BLVD, HOUSTON, TX 77005-1713
(713) 526-5511
(713) 520-4755
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
N4394
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306775301
—
TX
01
—
8DK018
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
—
P01110889
RR MEDICARE
TX
Enumeration date
06/19/2008
Last updated
03/09/2017
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