Provider Demographics
NPI:1629029673
Name:STARIN, PAULA J (CRNA)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:J
Last Name:STARIN
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 1:707 LIBERTY HL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-2139
Mailing Address - Country:US
Mailing Address - Phone:254-774-9604
Mailing Address - Fax:254-774-9604
Practice Address - Street 1:707 LIBERTY HL
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-2139
Practice Address - Country:US
Practice Address - Phone:254-774-9604
Practice Address - Fax:254-774-9604
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500724367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149972505Medicaid
TX149972505Medicaid