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Individual

DR. PAULINE A CLANSY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EDD

Contact information

Practice address
8303 SOUTHWEST FREEWAY, SUITE 640, HOUSTON, TX 77074
(713) 777-8633
(713) 777-5259
Mailing address
8303 SOUTHWEST FREEWAY, SUITE 640, HOUSTON, TX 77074
(713) 777-8633
(713) 777-5259

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
23329
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
032855101
TX
01
10016219
AMERIGROUP
TX
01
4356701
AETNA
01
760236166
MAGELLAN
TX
Enumeration date
09/20/2006
Last updated
07/08/2007
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