Provider Demographics
NPI:1720099112
Name:RAPP, MARY PAT (DSN,RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:PAT
Last Name:RAPP
Suffix:
Gender:F
Credentials:DSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8511 S SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4874
Mailing Address - Country:US
Mailing Address - Phone:713-343-2300
Mailing Address - Fax:888-232-8601
Practice Address - Street 1:8511 S SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4874
Practice Address - Country:US
Practice Address - Phone:713-343-2300
Practice Address - Fax:888-232-8601
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX462204363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101394801Medicaid
TXS22611Medicare UPIN
TX80N771Medicare ID - Type UnspecifiedGERIATRIC ASSOCIATES