Provider Demographics
NPI:1922264761
Name:JOY, SHAINI E (RN APN)
Entity Type:Individual
Prefix:
First Name:SHAINI
Middle Name:E
Last Name:JOY
Suffix:
Gender:F
Credentials:RN APN
Other - Prefix:
Other - First Name:SHAINI
Other - Middle Name:JOY
Other - Last Name:ELAVUMPARAMBIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN APN
Mailing Address - Street 1:PO BOX 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4009
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX704549363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196992501Medicaid
TX8L2652OtherBCBS
TX8L2652Medicare PIN