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General NPI Number Information
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NPI Number | 1003522525
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Entity Type | Individual
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Provider Name | ADAM NICHOLAS MYERS CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 815 N VIRGINIA ST
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City | PORT LAVACA
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State | TX
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Zip | 77979-3025
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Country | US
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Telephone | 361-552-0222
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Fax | 361-552-0220
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Provider Business Mailing Address
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Address Line | 403 WILLOWBEND DR
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City | PORT LAVACA
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State | TX
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Zip | 77979-2262
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Country | US
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Telephone | 817-879-3996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP1188082
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP61405206
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License Number State | WA
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