Provider Demographics
NPI:1710464748
Name:AVES, IOLANI MAE S
Entity Type:Individual
Prefix:
First Name:IOLANI MAE
Middle Name:S
Last Name:AVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9019 ACORN HARVEST TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30575 KINGSLAND BLVD # 150
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-2844
Practice Address - Country:US
Practice Address - Phone:281-717-4674
Practice Address - Fax:833-318-0533
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX716162363LF0000X
TXAP138328363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily