Healthcare Provider Details

I. General information

NPI: 1538535380
Provider Name (Legal Business Name): ALAIN AYMELE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5415 S MCCOLL RD
EDINBURG TX
78539-9183
US

IV. Provider business mailing address

5501 S MCCOLL RD
EDINBURG TX
78539-5503
US

V. Phone/Fax

Practice location:
  • Phone: 956-661-0529
  • Fax:
Mailing address:
  • Phone: 956-661-0529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2022035160
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number877689
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number27704
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: