Healthcare Provider Details

I. General information

NPI: 1568640613
Provider Name (Legal Business Name): KRISTIN JEAN MLINAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KRISTIN JEAN HARDMAN

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10777 KUYKENDAHL RD
THE WOODLANDS TX
77382-2772
US

IV. Provider business mailing address

9 GREENWAY PLZ SUITE 2950
HOUSTON TX
77046-0905
US

V. Phone/Fax

Practice location:
  • Phone: 281-907-4104
  • Fax:
Mailing address:
  • Phone: 866-607-7334
  • Fax: 713-358-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA05643
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: