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NPI Code Detail

MEDICARE: MARY CAROLYN WESSON CRNA

MEDICARE: MARY CAROLYN WESSON 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 Anesthetist598298TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1598298OTHERTXSTATE LICENSE NUMBER

General Provider Information

NPI Number : 1831226034
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY CAROLYN WESSON CRNA
Provider Business Mailing Address
First Line : 12657 DAIMLER DR
Second Line :
City : FRISCO
State : TX
Zip : 75034-5229
Country : US
Telephone Number : 662-213-1213
Fax Number :
Provider Business Practice Location Address
First Line : 1401 HENDERSON ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-6026
Country : US
Telephone Number : 662-213-1213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 05/13/2010

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Directions to “ MARY CAROLYN WESSON CRNA” Practice Location

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