Provider Demographics
NPI:1013249093
Name:SCHREIBER, SHANNON THIBODEAUX (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:THIBODEAUX
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:SHANNON
Other - Middle Name:MARIE
Other - Last Name:THIBODEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2537 S GESSNER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2032
Mailing Address - Country:US
Mailing Address - Phone:713-559-6929
Mailing Address - Fax:
Practice Address - Street 1:11800 ASTORIA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6041
Practice Address - Country:US
Practice Address - Phone:713-559-6929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718693367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered