Individual
NADA AWDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA-C
Contact information
Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(832) 355-2666
Mailing address
6720 BERTNER AVE STE O-520, HOUSTON, TX 77030-2604
(832) 355-2666
(832) 355-6500
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
10642
GA
367H00000X
Anesthesiologist Assistant
—
MO
367H00000X
Anesthesiologist Assistant
—
TX
Other
Enumeration date
07/27/2021
Last updated
11/27/2023
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