Provider Demographics
NPI:1922402106
Name:PAULTANIS, LOIDA ANITO (BSN,RN,CNOR,RNFA)
Entity Type:Individual
Prefix:MRS
First Name:LOIDA
Middle Name:ANITO
Last Name:PAULTANIS
Suffix:
Gender:F
Credentials:BSN,RN,CNOR,RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18327 SPRUCE CREEK DR
Mailing Address - Street 2:NONE
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2373
Mailing Address - Country:US
Mailing Address - Phone:281-389-8657
Mailing Address - Fax:
Practice Address - Street 1:18327 SPRUCE CREEK DR
Practice Address - Street 2:NONE
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2373
Practice Address - Country:US
Practice Address - Phone:281-389-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-16
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX773621163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant