MEDICARE: WILLIAM CAMBEL MCKENDRICK III 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	657458	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01146002	OTHER	TX	RR MEDICARE
3	467892ZM3W	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8733UD	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1912237868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM CAMBEL MCKENDRICK III CRNA

Provider Business Mailing Address
First Line	:	5900 BALCONES DR STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4298
Country	:	US
Telephone Number	:	818-889-3582
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 S GESSNER RD STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-3777
Country	:	US
Telephone Number	:	281-889-3582
Fax Number	:

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

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	05/09/2023

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