Provider Demographics
NPI:1235171778
Name:KORFIN, BRENDA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:KORFIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11910 KIMBERLEY LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7807
Mailing Address - Country:US
Mailing Address - Phone:713-463-9555
Mailing Address - Fax:
Practice Address - Street 1:15775 PARK TEN PL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5153
Practice Address - Country:US
Practice Address - Phone:281-647-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36396367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0028854Medicaid
TX0028854Medicaid