Provider Demographics
NPI:1104283662
Name:ROSENFELD, MARY LOUISE (WHNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LOUISE
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LOU
Other - Last Name:DIAMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WHNP
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:970
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-790-0099
Mailing Address - Fax:713-790-0527
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:970
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-790-0099
Practice Address - Fax:713-790-0527
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX236589363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health