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General NPI Number Information
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NPI Number | 1508848839
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Entity Type | Individual
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Provider Name | ANTONIO R ACOSTA DNP, APRN, CRNA, NSP
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 387 W INTERSTATE 10
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City | FORT STOCKTON
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State | TX
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Zip | 79735-2708
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Country | US
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Telephone | 432-336-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 9934 HUBBLE DR
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City | IOWA COLONY
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State | TX
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Zip | 77583-1503
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Country | US
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Telephone | 832-920-6451
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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 | 677410
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License Number State | TX
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