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General NPI Number Information
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NPI Number | 1548458433
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Entity Type | Individual
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Provider Name | JASON M BOATRIGHT CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 12222 MERIT DR STE 600
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City | DALLAS
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State | TX
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Zip | 75251-3294
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Country | US
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Telephone | 972-715-5000
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Fax | 972-715-9976
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE C B 8054
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1010
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Country | US
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Telephone | 314-362-6973
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Fax | 314-362-1185
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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 | AP119813
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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 | 151126
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License Number State | MO
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