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NPI Code Detail

MEDICARE: DAVID PROFIT JR. CRNA

MEDICARE:   DAVID  PROFIT JR. 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
1367500000XCertified Registered Nurse AnesthetistAP122105TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699035923
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID PROFIT JR. CRNA
Provider Business Mailing Address
First Line : PO BOX 66791
Second Line :
City : HOUSTON
State : TX
Zip : 77266-6791
Country : US
Telephone Number : 713-993-6053
Fax Number : 866-810-8005
Provider Business Practice Location Address
First Line : 800 WILCREST DR STE 213
Second Line :
City : HOUSTON
State : TX
Zip : 77042-1360
Country : US
Telephone Number : 713-993-6053
Fax Number : 866-810-8005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2012
Last Update Date : 10/25/2024

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