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General NPI Number Information
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NPI Number | 1619913779
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Entity Type | Individual
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Provider Name | ANDREW GRESHAM CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5501 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-9152
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Country | US
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Telephone | 956-661-0529
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Fax |
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Provider Business Mailing Address
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Address Line | 201 AUBURN AVE
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City | MCALLEN
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State | TX
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Zip | 78504-1994
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Country | US
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Telephone | 956-566-5060
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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 | RN530525L
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License Number State | PA
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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 | 3314
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 775203
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 719644
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License Number State | TX
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