Healthcare Provider Details

I. General information

NPI: 1235276155
Provider Name (Legal Business Name): WRENCH ANESTHESIA SERVICE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1072 E LOS EBANOS BLVD
BROWNSVILLE TX
78520-9988
US

IV. Provider business mailing address

PO BOX 3687
BROWNSVILLE TX
78523-3687
US

V. Phone/Fax

Practice location:
  • Phone: 956-541-1278
  • Fax: 956-541-2854
Mailing address:
  • Phone: 956-541-1278
  • Fax: 956-541-2854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM WRENCH
Title or Position: PRESIDENT
Credential: CRNA
Phone: 956-541-1278