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1043218811

NPI Code Detail

MEDICARE: LOUIS CRAIG LEGRAND CRNA

MEDICARE: LOUIS CRAIG LEGRAND CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	AP109190	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8739UJ	OTHER	TX	BCBS
2	430047728	OTHER		RAILROAD
3	81101H	OTHER	TX	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	98044	OTHER	AR	BLUE CROSS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043218811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS CRAIG LEGRAND CRNA

Provider Business Mailing Address
First Line	:	PO BOX 650865
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0865
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:	972-715-9976

Provider Business Practice Location Address
First Line	:	6606 LBJ FWY
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75240-6533
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:	972-715-9976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	03/28/2016

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Directions to “ LOUIS CRAIG LEGRAND CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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