MEDICARE: MR. ROBERT DWAYNE STEELE 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	254215	TX

General Provider Information

NPI Number	:	1134189681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT DWAYNE STEELE CRNA

Provider Business Mailing Address
First Line	:	13601 PRESTON RD
Second Line	:	900W
City	:	DALLAS
State	:	TX
Zip	:	75240-4911
Country	:	US
Telephone Number	:	972-233-1999
Fax Number	:	972-386-4292

Provider Business Practice Location Address
First Line	:	1105 CENTRAL EXPY N
Second Line	:	100
City	:	ALLEN
State	:	TX
Zip	:	75013-6103
Country	:	US
Telephone Number	:	972-747-6118
Fax Number	:	972-747-6121

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	07/09/2007

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