Provider Demographics
NPI:1932842093
Name:PAVLOVA, ALYONA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:ALYONA
Middle Name:
Last Name:PAVLOVA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 AUTUMN FOREST LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3731
Mailing Address - Country:US
Mailing Address - Phone:347-785-9485
Mailing Address - Fax:
Practice Address - Street 1:17070 RED OAK DR STE 405
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2616
Practice Address - Country:US
Practice Address - Phone:832-432-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074616363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily