Basic Information
Provider Information
NPI: 1497895973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINA
FirstName: MARY
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential: C.R.N.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: APPLEWHITE
OtherFirstName: MARY
OtherMiddleName: E.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2 E GREENWAY PLZ
Address2: SUITE 900
City: HOUSTON
State: TX
PostalCode: 770460297
CountryCode: US
TelephoneNumber: 7137981750
FaxNumber: 7137981144
Practice Location
Address1: 6621 FANNIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302303
CountryCode: US
TelephoneNumber: 8328245809
FaxNumber: 8328245801
Other Information
ProviderEnumerationDate: 02/07/2007
LastUpdateDate: 02/13/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X661636TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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