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General NPI Number Information
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NPI Number | 1366190001
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Entity Type | Individual
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Provider Name | TINA MARIE WASIELEWSKI
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Gender | Female
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 6720 BERTNER AVE
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 713-798-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 616 MEMORIAL HEIGHTS DR APT 9311
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City | HOUSTON
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State | TX
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Zip | 77007-6062
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Country | US
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Telephone | 716-319-4387
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1062350
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1062350
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License Number State | TX
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