Provider Demographics
NPI:1245272756
Name:MYNATT, ADRIENNE LYNETTE (NP)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LYNETTE
Last Name:MYNATT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2611 CYPRESS CREEK PKWY
Mailing Address - Street 2:STE D102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3731
Mailing Address - Country:US
Mailing Address - Phone:281-440-7399
Mailing Address - Fax:281-440-7403
Practice Address - Street 1:2611 CYPRESS CREEK PKWY
Practice Address - Street 2:STE D102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3731
Practice Address - Country:US
Practice Address - Phone:281-440-7399
Practice Address - Fax:281-440-7403
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2012-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX720296363LF0000X, 363LP0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX720296OtherTEXAS MEDICAL LICENSE