| NPI | 1174071880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY JOLLEY Director Of Credentialing 713-620-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |