Provider Demographics
NPI:1861757452
Name:DUREL, MOLLY REIMER (CRNA)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:REIMER
Last Name:DUREL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ANN
Other - Last Name:REIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3705 MEDICAL PKWY
Practice Address - Street 2:SUITE 570
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1019
Practice Address - Country:US
Practice Address - Phone:512-454-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121971367500000X
TX698862367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered