Provider Demographics
NPI:1740299510
Name:JOSWIAK, RENEA BEATRICE (CRNA)
Entity type:Individual
Prefix:
First Name:RENEA
Middle Name:BEATRICE
Last Name:JOSWIAK
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 1:2411 FOUNTAIN VIEW DR.
Mailing Address - Street 2:STE. 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4817
Mailing Address - Country:US
Mailing Address - Phone:713-620-4000
Mailing Address - Fax:
Practice Address - Street 1:2411 FOUNTAIN VIEW DR
Practice Address - Street 2:STE. 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4817
Practice Address - Country:US
Practice Address - Phone:713-620-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX453201367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86926UOtherBLUE CROSS BLUE SHIELD
TXP00790462OtherMEDICARE RAILROAD
TX088769704Medicaid
TX86609UOtherBLUE CROSS BLUE SHIELD
030810OtherAANA
TX86926UOtherBLUE CROSS BLUE SHIELD
TXP00790462OtherMEDICARE RAILROAD
TX8L19948Medicare PIN