Provider Demographics
NPI:1174587133
Name:MUNSTERMAN, CAROL LEE (CRNA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LEE
Last Name:MUNSTERMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-4997
Mailing Address - Fax:
Practice Address - Street 1:1500 CITYWEST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042
Practice Address - Country:US
Practice Address - Phone:713-620-4000
Practice Address - Fax:713-458-4229
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP105698367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00396673OtherRAILROAD MEDICARE
TXP01745842OtherRR MEDICARE
TX149206803Medicaid
TX486378YK6UOtherBCBS
TX86088UOtherBLUE CROSS PROVIDER ID
TX86315UOtherBLUE CROSS/BLUE SHIELD
TX8G5750Medicare ID - Type Unspecified
TX486378YK6UMedicare PIN
TX486378YK6UOtherBCBS
TXP01745842OtherRR MEDICARE