Healthcare Provider Details

I. General information

NPI: 1508079716
Provider Name (Legal Business Name): CHARLES P. MAYER ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 E NOLANA ST SUITE A
MCALLEN TX
78504-6114
US

IV. Provider business mailing address

PO BOX 3744
MCALLEN TX
78502-3744
US

V. Phone/Fax

Practice location:
  • Phone: 956-682-4151
  • Fax: 956-682-4154
Mailing address:
  • Phone: 956-682-4151
  • Fax: 956-682-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHARLES P MAYER
Title or Position: OWNER
Credential: CRNA
Phone: 956-682-4151