Healthcare Provider Details

I. General information

NPI: 1003822602
Provider Name (Legal Business Name): BRIAN R SCHWARTZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 HIGH RESORT BLVD SE # SW
RIO RANCHO NM
87124-5906
US

IV. Provider business mailing address

712 SONORA RD NE
RIO RANCHO NM
87144-7791
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2610
  • Fax:
Mailing address:
  • Phone: 505-896-9591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA00582
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: