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General NPI Number Information
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NPI Number | 1770761199
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Entity Type | Individual
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Provider Name | JAMES REYNALDO SHIPP CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 316 SANDPIPER AVE APT #1107
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City | MCALLEN
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State | TX
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Zip | 78504-1760
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Country | US
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Telephone | 318-470-5064
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 COLORADO ST APT #1107
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City | MISSION
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State | TX
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Zip | 78572-9589
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Country | US
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Telephone | 318-470-5064
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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 | 748784
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 748784
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License Number State | TX
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