Healthcare Provider Details

I. General information

NPI: 1881565901
Provider Name (Legal Business Name): MARY ELIZABETH IIAMS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 N HWY 75
DENISON TX
75020
US

IV. Provider business mailing address

5649 BOIS D ARC RD APT 5107
MCKINNEY TX
75071-5882
US

V. Phone/Fax

Practice location:
  • Phone: 903-416-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number151689
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: