Provider Demographics
NPI:1558685255
Name:STAINE-PYNE, PATRICIA ANNE I (RNBS,PHN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:STAINE-PYNE
Suffix:I
Gender:F
Credentials:RNBS,PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 MISTYWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-4739
Mailing Address - Country:US
Mailing Address - Phone:281-580-2270
Mailing Address - Fax:281-580-8297
Practice Address - Street 1:347 MISTYWOOD DR.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4739
Practice Address - Country:US
Practice Address - Phone:281-580-2270
Practice Address - Fax:281-580-8297
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX550213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX35Medicaid