MEDICARE: MRS. LOIDA ANITO PAULTANIS BSN,RN,CNOR,RNFA

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
1	163WR0006X	Registered Nurse First Assistant	773621	TX

General Provider Information

NPI Number	:	1922402106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LOIDA ANITO PAULTANIS BSN,RN,CNOR,RNFA

Provider Business Mailing Address
First Line	:	18327 SPRUCE CREEK DR
Second Line	:	NONE
City	:	HOUSTON
State	:	TX
Zip	:	77084-2373
Country	:	US
Telephone Number	:	281-389-8657
Fax Number	:

Provider Business Practice Location Address
First Line	:	18327 SPRUCE CREEK DR
Second Line	:	NONE
City	:	HOUSTON
State	:	TX
Zip	:	77084-2373
Country	:	US
Telephone Number	:	281-389-8657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2014
Last Update Date	:	10/16/2014

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