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General NPI Number Information
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NPI Number | 1972679736
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Entity Type | Individual
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Provider Name | EVANGELINE RABARA TREADWELL CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 2411 FOUNTAIN VIEW DR SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77057-4817
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Country | US
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Telephone | 903-530-9591
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Fax |
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Provider Business Mailing Address
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Address Line | 3115 COLLEGE PARK DR 107
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City | THE WOODLANDS
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State | TX
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Zip | 77384-4001
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Country | US
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Telephone | 936-494-3003
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 685367
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License Number State | TX
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