Provider Demographics
NPI:1871989947
Name:SCARIA, MINI THOMAS (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MINI
Middle Name:THOMAS
Last Name:SCARIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:MINI
Other - Middle Name:THOMAS
Other - Last Name:SCARIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2318 APPIAN WAY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8843
Mailing Address - Country:US
Mailing Address - Phone:832-814-8774
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:MEDVAMC
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126103363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care