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NPI Code Detail

MEDICARE: LOUIS T PENA CRNA

MEDICARE: LOUIS T PENA CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN038504LA
2367500000XCertified Registered Nurse AnesthetistAP102150TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013910520
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIS T PENA CRNA
Provider Business Mailing Address
First Line : 9333 ROSSTOWN WAY
Second Line :
City : HOUSTON
State : TX
Zip : 77080-7415
Country : US
Telephone Number : 713-822-1103
Fax Number : 713-932-6591
Provider Business Practice Location Address
First Line : 1635 NORTH LOOP W
Second Line :
City : HOUSTON
State : TX
Zip : 77008-1532
Country : US
Telephone Number : 713-400-2990
Fax Number : 713-400-2993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2005
Last Update Date : 11/21/2019

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Directions to “ LOUIS T PENA CRNA” Practice Location

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