Healthcare Provider Details

I. General information

NPI: 1669443131
Provider Name (Legal Business Name): RICHARD L HUFFMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4544 S LAMAR BLVD STE 700
AUSTIN TX
78745
US

IV. Provider business mailing address

15216 KEVIN LANE
AUSTIN TX
78734
US

V. Phone/Fax

Practice location:
  • Phone: 512-834-4141
  • Fax: 512-834-4142
Mailing address:
  • Phone: 573-578-7775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number887402
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP125181
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: