Provider Demographics
NPI:1194818591
Name:PAIRE, SHREDA (ARNP, FNP-C, ACHPN)
Entity type:Individual
Prefix:
First Name:SHREDA
Middle Name:
Last Name:PAIRE
Suffix:
Gender:F
Credentials:ARNP, FNP-C, ACHPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-5301
Mailing Address - Country:US
Mailing Address - Phone:713-530-0697
Mailing Address - Fax:
Practice Address - Street 1:915 W 41ST ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-5301
Practice Address - Country:US
Practice Address - Phone:713-530-0697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX620566163W00000X
TXAP113255363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
8Y9623OtherBLUE CROSS
8Y9623OtherBLUE CROSS