Provider Demographics
NPI:1003976168
Name:DOCTOLERO, HONEY MAE BALDOZA (CRNA)
Entity Type:Individual
Prefix:
First Name:HONEY
Middle Name:MAE BALDOZA
Last Name:DOCTOLERO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:HONEY
Other - Middle Name:MAE BALDOZA
Other - Last Name:DOCTOLERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-1022
Mailing Address - Country:US
Mailing Address - Phone:409-747-0890
Mailing Address - Fax:409-772-0885
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1022
Practice Address - Country:US
Practice Address - Phone:409-747-0890
Practice Address - Fax:409-772-0885
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621160367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165625801Medicaid
TX165625801Medicaid
TXQ07604Medicare UPIN