MEDICARE: NICHOLAS ANDREW PAGLIARI CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	828634	TX
2	367500000X	Certified Registered Nurse Anesthetist	10000562	OR
3	367500000X	Certified Registered Nurse Anesthetist	AP136225	TX

General Provider Information

NPI Number	:	1033627260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS ANDREW PAGLIARI CRNA

Provider Business Mailing Address
First Line	:	2407 S CONGRESS AVE # E499
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5505
Country	:	US
Telephone Number	:	615-332-2941
Fax Number	:

Provider Business Practice Location Address
First Line	:	2407 S CONGRESS AVE # E499
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5505
Country	:	US
Telephone Number	:	615-332-2941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2018
Last Update Date	:	01/03/2024

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