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General NPI Number Information
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NPI Number | 1013910520
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Entity Type | Individual
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Provider Name | LOUIS T PENA CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/30/2005
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 1635 NORTH LOOP W
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City | HOUSTON
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State | TX
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Zip | 77008-1532
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Country | US
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Telephone | 713-400-2990
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Fax | 713-400-2993
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Provider Business Mailing Address
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Address Line | 9333 ROSSTOWN WAY
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City | HOUSTON
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State | TX
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Zip | 77080-7415
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Country | US
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Telephone | 713-822-1103
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Fax | 713-932-6591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN038504
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP102150
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License Number State | TX
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