Individual
MARY ANN HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2411 FOUNTAIN VIEW DR, SUITE 200, HOUSTON, TX 77057-4817
(713) 458-4185
Mailing address
2411 FOUNTAIN VIEW DR STE 200, HOUSTON, TX 77057-4832
(713) 620-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
39370
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134804705
—
TX
05
—
1465666
—
LA
01
—
430027403
MEDICARE RAILROAD
—
01
—
88607C
TX-BLUE SHIELD
—
Enumeration date
01/10/2007
Last updated
11/02/2011
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