Provider Demographics
NPI:1336688936
Name:HERRERA, PAULA MARIA (SA-C, MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:SA-C, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 WESTHEIMER RD APT 4407
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-1812
Mailing Address - Country:US
Mailing Address - Phone:817-757-0281
Mailing Address - Fax:
Practice Address - Street 1:4410 WESTHEIMER RD APT 4407
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-1812
Practice Address - Country:US
Practice Address - Phone:817-757-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17-122246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant