Provider Demographics
NPI:1275195570
Name:NOURAIN, RAWDA
Entity type:Individual
Prefix:
First Name:RAWDA
Middle Name:
Last Name:NOURAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 RIVERSTONE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4092
Mailing Address - Country:US
Mailing Address - Phone:682-559-1339
Mailing Address - Fax:
Practice Address - Street 1:4810 RIVERSTONE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4092
Practice Address - Country:US
Practice Address - Phone:682-559-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX966581163W00000X
TX1158956363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse