Healthcare Provider Details

I. General information

NPI: 1093734675
Provider Name (Legal Business Name): MARK A ERSPAMER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 AVENUE E
HONDO TX
78861-3534
US

IV. Provider business mailing address

107 RIVER FRST
CASTROVILLE TX
78009-2715
US

V. Phone/Fax

Practice location:
  • Phone: 830-426-7700
  • Fax: 830-426-7860
Mailing address:
  • Phone: 830-538-3306
  • Fax: 830-538-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number243606
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: