Provider Demographics
NPI:1013038843
Name:UNDERWOOD, CAROL JEAN (BSN RN CCRC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:BSN RN CCRC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8119 BRIGHTON PLACE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2925
Mailing Address - Country:US
Mailing Address - Phone:281-861-8995
Mailing Address - Fax:
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-704-4230
Practice Address - Fax:713-704-5124
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251792163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine