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General NPI Number Information
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NPI Number | 1346839826
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Entity Type | Individual
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Provider Name | MICHAEL BERT OPPEN CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/11/2021
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 4502 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4402
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Country | US
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Telephone | 210-358-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 903 W MARTIN ST # MS 49-2
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City | SAN ANTONIO
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State | TX
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Zip | 78207-0903
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Country | US
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Telephone | 201-358-0572
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Fax | 210-358-5940
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 813040
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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 | 1029036
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License Number State | TX
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