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General NPI Number Information
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NPI Number | 1942244744
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Entity Type | Individual
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Provider Name | TIM KING CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 2412 50TH ST
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City | LUBBOCK
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State | TX
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Zip | 79412-2504
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Country | US
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Telephone | 806-744-7223
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Fax | 806-740-3325
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Provider Business Mailing Address
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Address Line | PO BOX 782
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City | ALAMO
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State | TX
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Zip | 78516-0782
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Country | US
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Telephone | 865-599-6127
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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 | APN10298
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License Number State | TN
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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 | ARNP1627092
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License Number State | FL
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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 | AP112805
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License Number State | TX
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